Provider Demographics
NPI:1629156823
Name:ART OF EYECARE, PC
Entity Type:Organization
Organization Name:ART OF EYECARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BERTON
Authorized Official - Last Name:PAULSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-734-6464
Mailing Address - Street 1:2151 SHENANGO VALLEY FWY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2586
Mailing Address - Country:US
Mailing Address - Phone:814-734-6464
Mailing Address - Fax:814-734-6363
Practice Address - Street 1:2151 SHENANGO VALLEY FWY
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2586
Practice Address - Country:US
Practice Address - Phone:724-346-5516
Practice Address - Fax:724-347-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000129152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1427700OtherBLUE CROSS/BLUE SHIELD
PA347708OtherHEALTH AMERICA
PA4628360001Medicare NSC