Provider Demographics
NPI:1326138868
Name:EYE WISE
Entity Type:Organization
Organization Name:EYE WISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HASHAAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHID
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:304-428-2777
Mailing Address - Street 1:103 NESHAMINY MALL
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1607
Mailing Address - Country:US
Mailing Address - Phone:215-942-7861
Mailing Address - Fax:215-942-7851
Practice Address - Street 1:103 NESHAMINY MALL
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1607
Practice Address - Country:US
Practice Address - Phone:215-942-7861
Practice Address - Fax:215-942-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty