Provider Demographics
NPI:1811008972
Name:MUDGIL EYE ASSOCIATES PC
Entity type:Organization
Organization Name:MUDGIL EYE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANANTH
Authorized Official - Middle Name:V
Authorized Official - Last Name:MUDGIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-429-3004
Mailing Address - Street 1:795 E MARSHALL ST STE 103
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4400
Mailing Address - Country:US
Mailing Address - Phone:610-429-3004
Mailing Address - Fax:610-429-3120
Practice Address - Street 1:795 E MARSHALL ST STE 103
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4400
Practice Address - Country:US
Practice Address - Phone:610-429-3004
Practice Address - Fax:610-429-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA063886Medicare ID - Type UnspecifiedGROUP ID NUMBER