Provider Demographics
NPI:1841790250
Name:WILLOW STREET EYE CARE, LLC
Entity Type:Organization
Organization Name:WILLOW STREET EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-464-7292
Mailing Address - Street 1:2904 WILLOW STREET PIKE N
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9227
Mailing Address - Country:US
Mailing Address - Phone:717-464-7292
Mailing Address - Fax:
Practice Address - Street 1:2904 WILLOW STREET PIKE N
Practice Address - Street 2:
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584-9227
Practice Address - Country:US
Practice Address - Phone:646-286-8310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty