NPIMap

Organization Active NPI

Aeg Pennsylvania Professional, Inc

Doing business as Yardley Vision Care

  • Optometrist
  • Yardley, PA
National Provider Identifier
1316711047
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AEG PENNSYLVANIA PROFESSIONAL, INC
Doing business as
Yardley Vision Care
Practice address
710 Floral Vale Blvd
Yardley, PA 19067-5529
Phone
(215) 550-6273
NPI assigned
Nov 13, 2023
Last updated
Nov 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AEG PENNSYLVANIA PROFESSIONAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Authorized official

Name
Benjamin Chudner, OD FAAO
Title
Owner
Phone
(360) 620-1186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

710 Floral Vale Blvd
Yardley, PA 19067-5529

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818

Other names 1

  • Yardley Vision Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aeg Pennsylvania Prof Inc29 organizations share this tax ID, including this one
Part of
Aeg Pennsylvania Prof Inc

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

710 Floral Vale Blvd
Yardley, PA 19067
Phone (215) 240-6378

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1316711047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 FLORAL VALE BLVD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675529",
            "telephone_number": "215-550-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "CHUDNER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-620-1186",
        "authorized_official_credential": "OD FAAO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yardley Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yardley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.