Provider Demographics
NPI:1881963874
Name:YARDLEY VISION CARE INC
Entity type:Organization
Organization Name:YARDLEY VISION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:COE
Authorized Official - Last Name:MAISEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:214-493-1924
Mailing Address - Street 1:1790 YARDLEY LANGHORNE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5523
Mailing Address - Country:US
Mailing Address - Phone:215-493-1924
Mailing Address - Fax:215-493-9805
Practice Address - Street 1:1790 YARDLEY LANGHORNE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5523
Practice Address - Country:US
Practice Address - Phone:215-493-1924
Practice Address - Fax:215-493-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE008487T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1295903896OtherNPI
PA233070Medicare PIN