Provider Demographics
NPI:1982763272
Name:LEVITTOWN EYE ASSOCIATES, INC.
Entity Type:Organization
Organization Name:LEVITTOWN EYE ASSOCIATES, INC.
Other - Org Name:ADVANCED EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:KNOX
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-946-8478
Mailing Address - Street 1:71 CRABTREE DR
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-1617
Mailing Address - Country:US
Mailing Address - Phone:215-946-8478
Mailing Address - Fax:215-946-4554
Practice Address - Street 1:71 CRABTREE DR
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-1617
Practice Address - Country:US
Practice Address - Phone:215-946-8478
Practice Address - Fax:267-202-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE006503T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0369630001Medicare NSC
PADP4179Medicare PIN
PA134058Medicare PIN