Provider Demographics
NPI:1639610629
Name:FOX CHASE FAMILY EYE CARE LLC
Entity Type:Organization
Organization Name:FOX CHASE FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:URIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHECHTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-745-0993
Mailing Address - Street 1:7834 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2219
Mailing Address - Country:US
Mailing Address - Phone:215-745-0993
Mailing Address - Fax:
Practice Address - Street 1:7834 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2219
Practice Address - Country:US
Practice Address - Phone:215-745-0993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003054152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30228118OtherKEYSTONE FIRST
PA7592991OtherAETNA
PA3936659000OtherINDEPENDENCE BLUECROSS KEYSTONE HEALTH PLAN EAST
1144604380OtherCOVENTRY HEALTH AMERICA
PA1030535100001Medicaid
NJ1144604380OtherHORIZON BLUECROSS BLUE SHIELD
PA3311193OtherHIGHMARK BLUE SHIELD
P01596991Medicare PIN
PA3936659000OtherINDEPENDENCE BLUECROSS KEYSTONE HEALTH PLAN EAST