Provider Demographics
NPI:1932466513
Name:EYE ASSOCIATES OF PRAIRIE VILLAGE,PA
Entity Type:Organization
Organization Name:EYE ASSOCIATES OF PRAIRIE VILLAGE,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PENNIPEDE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:913-339-9090
Mailing Address - Street 1:7632 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208
Mailing Address - Country:US
Mailing Address - Phone:913-642-5000
Mailing Address - Fax:913-648-6915
Practice Address - Street 1:7632 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3705
Practice Address - Country:US
Practice Address - Phone:913-642-5000
Practice Address - Fax:913-648-6915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty