Provider Demographics
NPI:1497377592
Name:DELAWARE VALLEY FAMILY EYE CARE PC
Entity Type:Organization
Organization Name:DELAWARE VALLEY FAMILY EYE CARE PC
Other - Org Name:PREMIER EYE CARE OF EWING P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SONAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:609-883-6500
Mailing Address - Street 1:1001 CITY AVE UNIT ED531
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3910
Mailing Address - Country:US
Mailing Address - Phone:732-804-2232
Mailing Address - Fax:
Practice Address - Street 1:860 LOWER FERRY RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-3525
Practice Address - Country:US
Practice Address - Phone:609-883-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty