Provider Demographics
NPI:1922166925
Name:E&J OPTICS INC
Entity Type:Organization
Organization Name:E&J OPTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCNAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-944-9814
Mailing Address - Street 1:4000 VINE ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-3565
Mailing Address - Country:US
Mailing Address - Phone:717-944-9814
Mailing Address - Fax:717-944-9814
Practice Address - Street 1:4000 VINE ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-3565
Practice Address - Country:US
Practice Address - Phone:717-944-9814
Practice Address - Fax:717-944-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA21053OtherGEISINGER HEALTH PLAN
PA50011233OtherCAPITAL BLUE
PA0012488500001Medicaid
PA000212063OtherBLUE CROSS BLUE SHIELD
PA000212063OtherBLUE CROSS BLUE SHIELD