Provider Demographics
NPI:1609016302
Name:EYEDOC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:EYEDOC ASSOCIATES, LLC
Other - Org Name:EYEDOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:UFUK
Authorized Official - Middle Name:FUSUN
Authorized Official - Last Name:CARDAKLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-943-7777
Mailing Address - Street 1:501 HOWARD AVE STE F3
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4818
Mailing Address - Country:US
Mailing Address - Phone:814-943-7777
Mailing Address - Fax:814-941-2015
Practice Address - Street 1:501 HOWARD AVE STE F3
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4818
Practice Address - Country:US
Practice Address - Phone:814-943-7777
Practice Address - Fax:814-941-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050928L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA148237OtherMEDICARE PTAN
PA1022836600001Medicaid