Provider Demographics
NPI:1285710483
Name:SOLL EYE PC OF PA
Entity type:Organization
Organization Name:SOLL EYE PC OF PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-288-5000
Mailing Address - Street 1:5001 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-2619
Mailing Address - Country:US
Mailing Address - Phone:215-288-5000
Mailing Address - Fax:215-744-1233
Practice Address - Street 1:10160 BUSTLETON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3749
Practice Address - Country:US
Practice Address - Phone:215-934-7655
Practice Address - Fax:215-934-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0603090004OtherEYEWEAR SUPPLIER
PA00039405OtherHIGHMARK GROUP NUMBER