Provider Demographics
NPI:1467420414
Name:ADVANCED EYE CARE P A
Entity type:Organization
Organization Name:ADVANCED EYE CARE P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:POPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-656-8867
Mailing Address - Street 1:213 GREENHILL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1844
Mailing Address - Country:US
Mailing Address - Phone:302-656-8867
Mailing Address - Fax:302-656-8594
Practice Address - Street 1:213 GREENHILL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1844
Practice Address - Country:US
Practice Address - Phone:302-656-8867
Practice Address - Fax:302-656-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0000716152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0669690001Medicare NSC