Provider Demographics
NPI:1265708614
Name:FREEPORT EYE CARE CENTER, INC
Entity type:Organization
Organization Name:FREEPORT EYE CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-295-5127
Mailing Address - Street 1:332 4TH ST
Mailing Address - Street 2:PO BOX 367
Mailing Address - City:FREEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16229-1130
Mailing Address - Country:US
Mailing Address - Phone:724-295-5127
Mailing Address - Fax:724-295-5130
Practice Address - Street 1:332 4TH ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:PA
Practice Address - Zip Code:16229-1130
Practice Address - Country:US
Practice Address - Phone:724-295-5127
Practice Address - Fax:724-295-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty