Provider Demographics
NPI:1245333467
Name:DALEY FAMILY EYE CARE PC
Entity type:Organization
Organization Name:DALEY FAMILY EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DALEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-485-4133
Mailing Address - Street 1:7297 CITO RD
Mailing Address - Street 2:
Mailing Address - City:MCCONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233
Mailing Address - Country:US
Mailing Address - Phone:717-485-4133
Mailing Address - Fax:717-485-4179
Practice Address - Street 1:7297 CITO RD
Practice Address - Street 2:
Practice Address - City:MCCONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233
Practice Address - Country:US
Practice Address - Phone:717-485-4133
Practice Address - Fax:717-485-4179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000012152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
087070Medicare ID - Type Unspecified
5349050001Medicare NSC
PA087070Medicare PIN
U63812Medicare UPIN