Provider Demographics
NPI:1851975312
Name:CITY LINE EYE CARE LLC
Entity Type:Organization
Organization Name:CITY LINE EYE CARE LLC
Other - Org Name:CITY AVE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TU
Authorized Official - Middle Name:X
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-206-3866
Mailing Address - Street 1:49 E CITY AVE # 10
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2421
Mailing Address - Country:US
Mailing Address - Phone:610-206-3866
Mailing Address - Fax:610-206-3836
Practice Address - Street 1:49 E CITY AVE # 10
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2421
Practice Address - Country:US
Practice Address - Phone:610-206-3866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty