Provider Demographics
NPI:1275732232
Name:B&J OPTICS
Entity Type:Organization
Organization Name:B&J OPTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAGHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-992-3090
Mailing Address - Street 1:727 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-2315
Mailing Address - Country:US
Mailing Address - Phone:215-992-3090
Mailing Address - Fax:
Practice Address - Street 1:727 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19106-2315
Practice Address - Country:US
Practice Address - Phone:215-992-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAYER OPTICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-11
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0052327OtherAETNA
PA66552OtherHIGHMARK PA
PA66552OtherHIGHMARK PA
PA0515980001Medicare NSC