Provider Demographics
NPI:1003845231
Name:EYE PHYSICIANS OF LANCASTER PC
Entity Type:Organization
Organization Name:EYE PHYSICIANS OF LANCASTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:KRULEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:717-735-6700
Mailing Address - Street 1:810 PLAZA BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2738
Mailing Address - Country:US
Mailing Address - Phone:717-735-6700
Mailing Address - Fax:717-735-8113
Practice Address - Street 1:810 PLAZA BLVD
Practice Address - Street 2:STE 103
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2738
Practice Address - Country:US
Practice Address - Phone:717-735-6700
Practice Address - Fax:717-735-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014694590002Medicaid
PA0014694590002Medicaid
PAF4250Medicare PIN
PA135442Medicare PIN