Provider Demographics
NPI:1801207097
Name:INFINITY EYE CARE, PC
Entity type:Organization
Organization Name:INFINITY EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIBURTINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:646-286-8330
Mailing Address - Street 1:364 BRECKENRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2988
Mailing Address - Country:US
Mailing Address - Phone:646-286-8330
Mailing Address - Fax:717-490-6218
Practice Address - Street 1:845 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3224
Practice Address - Country:US
Practice Address - Phone:717-393-8230
Practice Address - Fax:717-490-6218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-10
Last Update Date:2014-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002863152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty