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NPI Code Detail

MEDICARE: THE ELDER EYE CARE GROUP, INC

MEDICARE: THE ELDER EYE CARE GROUP, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOEG1131PA

General Provider Information

NPI Number : 1265469654
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE ELDER EYE CARE GROUP, INC
Provider Business Mailing Address
First Line : 118 TROTTERS DR
Second Line :
City : PHOENIXVILLE
State : PA
Zip : 19460-2368
Country : US
Telephone Number : 610-983-0841
Fax Number :
Provider Business Practice Location Address
First Line : 706 VILLAGE AT ELAND
Second Line : SUITE 706
City : PHOENIXVILLE
State : PA
Zip : 19460-2284
Country : US
Telephone Number : 610-917-9999
Fax Number : 610-917-9978
Authorized Official
Title or Position : OWNER
Name : DR. GREGORY WILLIAM VALLINO
Credential : O.D.
Telephone Number : 610-917-9999
Provider Enumeration Date : 06/28/2006
Last Update Date : 06/13/2016

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Directions to “THE ELDER EYE CARE GROUP, INC ” Practice Location

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