Provider Demographics
NPI:1518998103
Name:MIDDLETOWN EYE CARE PA
Entity Type:Organization
Organization Name:MIDDLETOWN EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:BESSIE
Authorized Official - Last Name:CLUFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-378-8818
Mailing Address - Street 1:228 DOVE RUN CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-7971
Mailing Address - Country:US
Mailing Address - Phone:302-378-8818
Mailing Address - Fax:302-378-2371
Practice Address - Street 1:228 DOVE RUN CENTRE DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-7971
Practice Address - Country:US
Practice Address - Phone:302-378-8818
Practice Address - Fax:302-378-2371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE I3-1235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00332068OtherAMERIHEALTH PPO
DE05435504OtherCIGNA
DE06083OtherSPECTERA
DE000884645Medicaid
DE0671527000OtherAMERIHEALTH HMO
DE39755OtherDAVIS
DE2017754OtherAETNA
DE=========OtherDEVON
DE000884645Medicaid
DE=========OtherBLUE CROSS BLUE SHIELD
DE0671527000OtherAMERIHEALTH HMO
DE=========OtherSUPERIORVISION
DE0671527000OtherAMERIHEALTH HMO
DE=========OtherDEVON
DE=========OtherVISIONBENEFITSOFAMERICA
DE2017754OtherAETNA