Provider Demographics
NPI:1891115291
Name:TODD PIERZCHALA, O.D., P.C.
Entity Type:Organization
Organization Name:TODD PIERZCHALA, O.D., P.C.
Other - Org Name:DR. TODD PIERZCHALA & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST / CORPORATION PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIERZCHALA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-343-6315
Mailing Address - Street 1:25 KULP RD E
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3731
Mailing Address - Country:US
Mailing Address - Phone:215-343-6315
Mailing Address - Fax:
Practice Address - Street 1:195 N WEST END BLVD
Practice Address - Street 2:C/O WALMART VISION CENTER
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-2306
Practice Address - Country:US
Practice Address - Phone:215-529-7948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000528152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPI004319OtherMEDICARE PROVIDER NUMBER
PAPI004319OtherMEDICARE PROVIDER NUMBER