Provider Demographics
NPI:1396143236
Name:ABRAHAM EYE ASSOCIATES LLC
Entity type:Organization
Organization Name:ABRAHAM EYE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-491-2125
Mailing Address - Street 1:1149 W LANCASTER AVE
Mailing Address - Street 2:U5
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2722
Mailing Address - Country:US
Mailing Address - Phone:610-572-3073
Mailing Address - Fax:
Practice Address - Street 1:1149 W LANCASTER AVE
Practice Address - Street 2:U5
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2722
Practice Address - Country:US
Practice Address - Phone:610-572-3073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty