Provider Demographics
NPI:1609898147
Name:ANDREW N. BAUSCH, M.D., P.C.
Entity Type:Organization
Organization Name:ANDREW N. BAUSCH, M.D., P.C.
Other - Org Name:PLAZA WEST OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:N
Authorized Official - Last Name:BAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-432-0201
Mailing Address - Street 1:1616 W ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-2012
Mailing Address - Country:US
Mailing Address - Phone:610-432-0201
Mailing Address - Fax:610-434-1210
Practice Address - Street 1:1616 W ALLEN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2012
Practice Address - Country:US
Practice Address - Phone:610-432-0201
Practice Address - Fax:610-434-1210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANDREW N BAUSCH, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3956190001Medicare NSC