Provider Demographics
NPI:1467294298
Name:CHRISTIANA EYECARE LLC
Entity type:Organization
Organization Name:CHRISTIANA EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:FOSTER
Authorized Official - Last Name:SHUKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-701-3007
Mailing Address - Street 1:316 NEWPORT AVE
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:PA
Mailing Address - Zip Code:17509-1312
Mailing Address - Country:US
Mailing Address - Phone:610-593-6670
Mailing Address - Fax:610-593-2327
Practice Address - Street 1:316 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANA
Practice Address - State:PA
Practice Address - Zip Code:17509-1312
Practice Address - Country:US
Practice Address - Phone:610-593-6670
Practice Address - Fax:610-593-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty