Eye Site

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE SITE

Practice address

30 S Macdade Blvd
Glenolden, PA 19036-1725

Phone

(610) 586-0651

NPI assigned

Nov 28, 2007

Last updated

Nov 28, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Diane Walker

Title

Owner

Phone

(610) 586-0651

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1104008416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 S MACDADE BLVD",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361725",
            "telephone_number": "610-586-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 S MACDADE BLVD",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361725",
            "telephone_number": "610-586-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-586-0651",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elwyn
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• Optometrist in Glenolden, PA
• Providers in Glenolden, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.