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NPI Code Detail

MEDICARE: EYE TO EYE VISIONCARE

MEDICARE: EYE TO EYE VISIONCARE
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
1152W00000XOptometrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13259OTHEROHSTATE LICENSE
26343OTHEROHSTATE LICENSE

General Provider Information

NPI Number : 1689144149
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE TO EYE VISIONCARE
Provider Business Mailing Address
First Line : 400 MILL AVE SE STE 329
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-3876
Country : US
Telephone Number : 330-339-8788
Fax Number :
Provider Business Practice Location Address
First Line : 400 MILL AVE SE STE 329
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-3876
Country : US
Telephone Number : 330-339-8788
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST/OWNER
Name : DR. MAGGIE A HERMAN
Credential : OD
Telephone Number : 330-339-8788
Provider Enumeration Date : 11/27/2018
Last Update Date : 11/27/2018

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Directions to “EYE TO EYE VISIONCARE ” Practice Location

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