Provider Demographics
NPI:1558349530
Name:SANDFORD C FRISCH MD
Entity Type:Organization
Organization Name:SANDFORD C FRISCH MD
Other - Org Name:EYE HEALTH PHYSICIANS OF LANCASTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:PAMELA
Authorized Official - Last Name:FRISCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-569-0600
Mailing Address - Street 1:2207 OREGON PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4606
Mailing Address - Country:US
Mailing Address - Phone:717-569-0600
Mailing Address - Fax:717-569-4562
Practice Address - Street 1:2207 OREGON PIKE
Practice Address - Street 2:SUITE 102
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4606
Practice Address - Country:US
Practice Address - Phone:717-569-0600
Practice Address - Fax:717-569-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042342E207W00000X
PA6000006421332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03046900OtherCAPITAL BLUE CROSS
107613OtherHIGHMARK BLUE SHIELD
PA045620OtherGROUP PTAN NUMBER
PA03046900OtherCAPITAL BLUE CROSS
PA0729330001Medicare NSC