Provider Demographics
NPI:1346506250
Name:SANS PAREIL EYECARE
Entity Type:Organization
Organization Name:SANS PAREIL EYECARE
Other - Org Name:WHEATLYN EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:POLLECK
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-266-5661
Mailing Address - Street 1:234 ROSEDALE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:17345-1023
Mailing Address - Country:US
Mailing Address - Phone:717-266-5661
Mailing Address - Fax:717-266-6510
Practice Address - Street 1:234 ROSEDALE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:PA
Practice Address - Zip Code:17345-1023
Practice Address - Country:US
Practice Address - Phone:717-266-5661
Practice Address - Fax:717-266-6510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000113152W00000X, 152WC0802X
PAOEG001473152W00000X, 152WC0802X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50109206OtherCAPITAL BLUE CROSS
PA241810Medicare PIN