Provider Demographics
NPI:1609252899
Name:EYECARE CENTER OF KEN CARYL, PC
Entity Type:Organization
Organization Name:EYECARE CENTER OF KEN CARYL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-870-1123
Mailing Address - Street 1:5187 S FRASER WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2279
Mailing Address - Country:US
Mailing Address - Phone:303-870-1123
Mailing Address - Fax:
Practice Address - Street 1:11550 W MEADOWS DR
Practice Address - Street 2:#F
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-5862
Practice Address - Country:US
Practice Address - Phone:303-870-1123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3073152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty