Provider Demographics
NPI:1720262538
Name:TRI COUNTY EYE PHYSICIANS & SURGEONS P.C.
Entity Type:Organization
Organization Name:TRI COUNTY EYE PHYSICIANS & SURGEONS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:COA
Authorized Official - Phone:215-396-4213
Mailing Address - Street 1:319 SECOND STREET PIKE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-3812
Mailing Address - Country:US
Mailing Address - Phone:215-355-4428
Mailing Address - Fax:215-256-2584
Practice Address - Street 1:319 SECOND STREET PIKE
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3812
Practice Address - Country:US
Practice Address - Phone:215-355-4428
Practice Address - Fax:215-256-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031499E332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0187170003Medicare NSC
PA0187170001Medicare NSC