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General NPI Number Information
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NPI Number | 1982600136
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Entity Type | Organization
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Legal Business Name | BERKS FAMILY EYECARE P C
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 247 E PENN AVE
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City | WERNERSVILLE
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State | PA
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Zip | 19565-1613
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Country | US
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Telephone | 610-678-7202
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Fax | 610-678-9866
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Provider Business Mailing Address
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Address Line | 247 E PENN AVE
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City | WERNERSVILLE
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State | PA
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Zip | 19565-1613
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Country | US
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Telephone | 610-678-7202
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Fax | 610-678-9866
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KIMBERLY ANN MILLER
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Credential |
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Telephone | 610-678-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | OEG000172
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG000172
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License Number State | PA
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