Provider Demographics
NPI:1831195213
Name:OPHTHALMOLOGY CONSULTING SERVICES, PC
Entity type:Organization
Organization Name:OPHTHALMOLOGY CONSULTING SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR/ACTIVE, ATTENDING
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARKOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-825-8210
Mailing Address - Street 1:482 NORRISTOWN RD STE 111
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2349
Mailing Address - Country:US
Mailing Address - Phone:610-825-8210
Mailing Address - Fax:610-825-8208
Practice Address - Street 1:482 NORRISTOWN RD STE 111
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2349
Practice Address - Country:US
Practice Address - Phone:610-825-8210
Practice Address - Fax:610-825-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05816900207W00000X
PAMD051757L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8033200Medicaid
PA001803305003Medicaid
NJ027448Medicare PIN
PA023898Medicare PIN