Provider Demographics
NPI:1952485294
Name:I DO EYES, INC
Entity type:Organization
Organization Name:I DO EYES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-355-1300
Mailing Address - Street 1:225 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6448
Mailing Address - Country:US
Mailing Address - Phone:215-355-1300
Mailing Address - Fax:215-355-8745
Practice Address - Street 1:504 NEWPORT CIR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19053-2489
Practice Address - Country:US
Practice Address - Phone:215-355-1300
Practice Address - Fax:215-355-8745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-000757152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPA95902OtherVBA
PA3982183OtherAETNA
PA086442974OtherVSP
PA119455TNBOtherNOVITAS SOLUTIONS-CMS
PAT29222Medicare UPIN