Provider Demographics
NPI:1356505663
Name:A & A EYE ASSOCIATES, PC
Entity Type:Organization
Organization Name:A & A EYE ASSOCIATES, PC
Other - Org Name:ADVANCED EYE CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-231-3937
Mailing Address - Street 1:1470 MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-3065
Mailing Address - Country:US
Mailing Address - Phone:814-231-3937
Mailing Address - Fax:814-231-0726
Practice Address - Street 1:1470 MARTIN STREET
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-3065
Practice Address - Country:US
Practice Address - Phone:814-231-3937
Practice Address - Fax:814-231-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000690332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1310400001Medicare NSC