Provider Demographics
NPI:1083171425
Name:THE EYE CENTER OF GARDEN CITY PA
Entity Type:Organization
Organization Name:THE EYE CENTER OF GARDEN CITY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:620-521-9791
Mailing Address - Street 1:3101 E KANSAS AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-6994
Mailing Address - Country:US
Mailing Address - Phone:620-272-9667
Mailing Address - Fax:620-260-9548
Practice Address - Street 1:3101 E KANSAS AVE STE 9
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-6994
Practice Address - Country:US
Practice Address - Phone:620-272-9667
Practice Address - Fax:620-260-9548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty