Provider Demographics
NPI:1467546499
Name:FAMILY EYE CARE OF NEPA PC
Entity Type:Organization
Organization Name:FAMILY EYE CARE OF NEPA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DZWIELESKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-253-6551
Mailing Address - Street 1:3373 LAKE ARIEL HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1174
Mailing Address - Country:US
Mailing Address - Phone:570-253-6551
Mailing Address - Fax:570-256-6553
Practice Address - Street 1:3373 LAKE ARIEL HWY
Practice Address - Street 2:SUITE C
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1174
Practice Address - Country:US
Practice Address - Phone:570-253-6551
Practice Address - Fax:570-256-6553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2527421OtherAETNA
PA5269540001OtherDMERC
PAFA1649039OtherBLUE CROSS BLUE SHIELD
PA49748OtherDAVIS
PA1011406350001Medicaid
PA812741OtherFIRST PRIORITY
PAFA1649039OtherBLUE CROSS BLUE SHIELD