Provider Demographics
NPI:1689725624
Name:ALLEN SOFFER OD PC
Entity Type:Organization
Organization Name:ALLEN SOFFER OD PC
Other - Org Name:SOFFER EYE CARE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OD PC
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SOFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-279-0431
Mailing Address - Street 1:217 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-4657
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:217 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-4657
Practice Address - Country:US
Practice Address - Phone:610-279-0431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001357152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMS0937182OtherDEA
PA0651430001Medicare NSC
PA177398Medicare PIN
PACF4483Medicare PIN