Provider Demographics
NPI:1316977341
Name:EYECARE OF THE VALLEY P.C.
Entity type:Organization
Organization Name:EYECARE OF THE VALLEY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:EISS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-679-3500
Mailing Address - Street 1:240 POTTSTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-1807
Mailing Address - Country:US
Mailing Address - Phone:215-679-3500
Mailing Address - Fax:215-679-3096
Practice Address - Street 1:240 POTTSTOWN AVE
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1807
Practice Address - Country:US
Practice Address - Phone:215-679-3500
Practice Address - Fax:215-679-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000409152W00000X
PAMD015132E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA016259Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
PA1254060001Medicare NSC