Provider Demographics
NPI:1013949874
Name:EYE PLASTIC SURGERY LTD
Entity Type:Organization
Organization Name:EYE PLASTIC SURGERY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-918-5552
Mailing Address - Street 1:610 W GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 161
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1050
Mailing Address - Country:US
Mailing Address - Phone:610-828-8880
Mailing Address - Fax:610-828-8883
Practice Address - Street 1:610 W GERMANTOWN PIKE
Practice Address - Street 2:SUITE 161
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1062
Practice Address - Country:US
Practice Address - Phone:610-828-8880
Practice Address - Fax:610-828-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD027087E207W00000X
208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B41487Medicare UPIN