Provider Demographics
NPI:1619923075
Name:WARRINGTON EYE CARE PC
Entity Type:Organization
Organization Name:WARRINGTON EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:SIEG
Authorized Official - Last Name:KUENY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-491-6000
Mailing Address - Street 1:1432 EASTON RD
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2852
Mailing Address - Country:US
Mailing Address - Phone:215-491-6000
Mailing Address - Fax:
Practice Address - Street 1:1432 EASTON RD
Practice Address - Street 2:SUITE 3E
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2852
Practice Address - Country:US
Practice Address - Phone:215-491-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001648152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014502800001Medicaid
PA091374Medicare ID - Type Unspecified
PA1014502800001Medicaid