Provider Demographics
NPI:1659051456
Name:AURORA VISION
Entity Type:Organization
Organization Name:AURORA VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-834-2563
Mailing Address - Street 1:134 PLYMOUTH RD UNIT 5409
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1472
Mailing Address - Country:US
Mailing Address - Phone:215-834-2563
Mailing Address - Fax:
Practice Address - Street 1:4000 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1600
Practice Address - Country:US
Practice Address - Phone:215-220-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty