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General NPI Number Information
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NPI Number | 1316977341
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Entity Type | Organization
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Legal Business Name | EYECARE OF THE VALLEY P.C.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 240 POTTSTOWN AVE
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City | PENNSBURG
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State | PA
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Zip | 18073-1807
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Country | US
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Telephone | 215-679-3500
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Fax | 215-679-3096
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Provider Business Mailing Address
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Address Line | 240 POTTSTOWN AVE
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City | PENNSBURG
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State | PA
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Zip | 18073-1807
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Country | US
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Telephone | 215-679-3500
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Fax | 215-679-3096
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. STEVEN PAUL EISS
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Credential | O.D.
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Telephone | 215-679-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG000409
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD015132E
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License Number State | PA
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