Provider Demographics
NPI:1124196522
Name:EYESHADE SHOPPE INC
Entity Type:Organization
Organization Name:EYESHADE SHOPPE INC
Other - Org Name:SUNRISE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-938-0999
Mailing Address - Street 1:2381 PHILMONT AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6236
Mailing Address - Country:US
Mailing Address - Phone:215-938-0999
Mailing Address - Fax:215-938-7447
Practice Address - Street 1:135 YORKTOWN PLZ
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1420
Practice Address - Country:US
Practice Address - Phone:215-886-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty