Provider Demographics
NPI:1063586709
Name:DRS E L AND R H KANE PC
Entity type:Organization
Organization Name:DRS E L AND R H KANE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:610-566-1693
Mailing Address - Street 1:24 E SECOND ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2906
Mailing Address - Country:US
Mailing Address - Phone:610-566-1693
Mailing Address - Fax:610-566-2229
Practice Address - Street 1:24 E SECOND ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2906
Practice Address - Country:US
Practice Address - Phone:610-566-1693
Practice Address - Fax:610-566-2229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3503152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0681790001OtherDMEC MEDICARE
PAC13644OtherRAILROAD MEDICARE
PA507553Medicare PIN