Provider Demographics
NPI:1265515746
Name:BAINBRIDGE EYE CARE ASSOCIATES, INC.
Entity type:Organization
Organization Name:BAINBRIDGE EYE CARE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:BAINBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-692-2212
Mailing Address - Street 1:1255 WEST CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5646
Mailing Address - Country:US
Mailing Address - Phone:610-692-2212
Mailing Address - Fax:610-692-2235
Practice Address - Street 1:1255 WEST CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-5646
Practice Address - Country:US
Practice Address - Phone:610-692-2212
Practice Address - Fax:610-692-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000596152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1618698OtherPERSONAL CHOISE
PA1618698OtherHIGHMARK BLUE SHIELD
PA1618698OtherPREMIER BLUE SHIELD
PA1618698OtherINDEPENDENCE BLUE CROSS
PA2658183OtherAETAN
PA2301209000OtherKEYSTONE HEALTHCARE EAST
PA1618698OtherPREMIER BLUE SHIELD
5638880001Medicare NSC
PA2658183OtherAETAN