Provider Demographics
NPI:1629278056
Name:OPHTHALMIC CONSULTANTS LTD
Entity Type:Organization
Organization Name:OPHTHALMIC CONSULTANTS LTD
Other - Org Name:VISTARR LASER AND VISION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IGNATIUS
Authorized Official - Middle Name:S
Authorized Official - Last Name:HNELESKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:610-692-8100
Mailing Address - Street 1:845 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4878
Mailing Address - Country:US
Mailing Address - Phone:610-692-8100
Mailing Address - Fax:610-436-4011
Practice Address - Street 1:404 MCFARLAN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-2479
Practice Address - Country:US
Practice Address - Phone:610-444-1519
Practice Address - Fax:610-436-4011
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPHTHALMIC CONSULTANTS LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-24
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA039425Medicare PIN