Provider Demographics
NPI:1588813877
Name:DR. ALLAN S. TOCKER & ASSOC., OPTOMETRY PA
Entity Type:Organization
Organization Name:DR. ALLAN S. TOCKER & ASSOC., OPTOMETRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/VP
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:STEHEN
Authorized Official - Last Name:TOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-995-9060
Mailing Address - Street 1:5151 W WOODMILL DR STE 19
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4067
Mailing Address - Country:US
Mailing Address - Phone:302-995-9060
Mailing Address - Fax:302-995-9064
Practice Address - Street 1:5151 W WOODMILL DR STE 19
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4067
Practice Address - Country:US
Practice Address - Phone:302-995-9060
Practice Address - Fax:302-995-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE1164152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DET412105Medicare PIN