Provider Demographics
NPI:1699128256
Name:EYEWEAR OPTICAL INC.
Entity type:Organization
Organization Name:EYEWEAR OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-478-8000
Mailing Address - Street 1:13 KEDRON AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:PA
Mailing Address - Zip Code:19070-1513
Mailing Address - Country:US
Mailing Address - Phone:484-478-8000
Mailing Address - Fax:484-478-0600
Practice Address - Street 1:13 KEDRON AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1513
Practice Address - Country:US
Practice Address - Phone:484-478-8000
Practice Address - Fax:484-478-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty