Provider Demographics
NPI:1417443177
Name:VISUALEYES OPTIQUE PLLC
Entity Type:Organization
Organization Name:VISUALEYES OPTIQUE PLLC
Other - Org Name:VISUALEYES OPTIQUE PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-448-9910
Mailing Address - Street 1:12 GENERAL WARREN BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1245
Mailing Address - Country:US
Mailing Address - Phone:610-448-9910
Mailing Address - Fax:610-448-9908
Practice Address - Street 1:12 GENERAL WARREN BLVD STE 700
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1245
Practice Address - Country:US
Practice Address - Phone:610-448-9910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-06
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002171152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1114124385OtherINDIVIDUAL NPI