Provider Demographics
NPI:1700831609
Name:WHITING FAMILY VISION CARE, PC
Entity Type:Organization
Organization Name:WHITING FAMILY VISION CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:WHITING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-946-2620
Mailing Address - Street 1:2055 MERCER NEW WILMINGTON RD
Mailing Address - Street 2:STE 3
Mailing Address - City:NEW WILMINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16142-2027
Mailing Address - Country:US
Mailing Address - Phone:724-946-2620
Mailing Address - Fax:724-946-2622
Practice Address - Street 1:2055 MERCER NEW WILMINGTON RD
Practice Address - Street 2:STE 3
Practice Address - City:NEW WILMINGTON
Practice Address - State:PA
Practice Address - Zip Code:16142-2027
Practice Address - Country:US
Practice Address - Phone:724-946-2620
Practice Address - Fax:724-946-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG 001658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA095885Medicare PIN
PA5704570001Medicare NSC