Provider Demographics
NPI:1316091242
Name:EYE CARE SPECIALISTS, P.C.
Entity type:Organization
Organization Name:EYE CARE SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:F
Authorized Official - Last Name:KRUGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-288-7405
Mailing Address - Street 1:703 RUTTER AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-4801
Mailing Address - Country:US
Mailing Address - Phone:570-288-7405
Mailing Address - Fax:570-288-7406
Practice Address - Street 1:789 AIRPORT RD STE 105
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-3294
Practice Address - Country:US
Practice Address - Phone:570-455-3391
Practice Address - Fax:570-455-9150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010897540025Medicaid
PA181248Medicare PIN