Provider Demographics
NPI:1992705651
Name:MOORE EYE CARE, P.C.
Entity type:Organization
Organization Name:MOORE EYE CARE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-422-5000
Mailing Address - Street 1:1001 BALTIMORE PIKE STE 208
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2852
Mailing Address - Country:US
Mailing Address - Phone:610-690-4900
Mailing Address - Fax:610-690-4910
Practice Address - Street 1:1001 BALTIMORE PIKE STE 208
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2852
Practice Address - Country:US
Practice Address - Phone:610-690-4900
Practice Address - Fax:610-690-4910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOORE EYE CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-26
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152WL0500X, 207WX0009X, 207WX0107X, 207WX0120X
PAMD041611L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Multi-Specialty
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA524894Medicare PIN