Provider Demographics
NPI:1285626440
Name:EBH EYE ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:EBH EYE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:BC
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-922-6288
Mailing Address - Street 1:215 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1832
Mailing Address - Country:US
Mailing Address - Phone:215-922-6288
Mailing Address - Fax:
Practice Address - Street 1:215 N 9TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1832
Practice Address - Country:US
Practice Address - Phone:215-922-6288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001435152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAEB1686405OtherHIGHMARK BS
PA080346Medicare ID - Type Unspecified