Provider Demographics
NPI:1538302096
Name:EYECANDY OPTICAL LLC
Entity Type:Organization
Organization Name:EYECANDY OPTICAL LLC
Other - Org Name:COHEN'S FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:HABERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-757-4111
Mailing Address - Street 1:2300 E LINCOLN HWY
Mailing Address - Street 2:OXFORD VALLEY MALL STORE # 224
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1824
Mailing Address - Country:US
Mailing Address - Phone:215-757-4111
Mailing Address - Fax:215-757-0455
Practice Address - Street 1:2300 E LINCOLN HWY
Practice Address - Street 2:OXFORD VALLEY MALL STORE # 224
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1824
Practice Address - Country:US
Practice Address - Phone:215-757-4111
Practice Address - Fax:215-757-0455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEP008528152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty