Provider Demographics
NPI:1508899618
Name:OCULAR TELEHEALTH MANAGEMENT, LLC
Entity Type:Organization
Organization Name:OCULAR TELEHEALTH MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAE
Authorized Official - Middle Name:
Authorized Official - Last Name:REBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-317-2622
Mailing Address - Street 1:565 E SWEDESFORD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1611
Mailing Address - Country:US
Mailing Address - Phone:610-688-8152
Mailing Address - Fax:610-688-3641
Practice Address - Street 1:1068 W BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5104
Practice Address - Country:US
Practice Address - Phone:610-688-8152
Practice Address - Fax:610-688-3641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA018373Medicare ID - Type Unspecified
PA069157Medicare ID - Type Unspecified
PA018360Medicare ID - Type Unspecified