Russin Eye LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

OS009908L Issued in PA

Legal business name

RUSSIN EYE LLC

Practice address

301 City Avenue
Suite 335
Bala Cynwood, PA 19004

Phone

(610) 617-4177

Fax

(610) 617-4170

NPI assigned

May 12, 2008

Last updated

Oct 1, 2008By 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

Simon R Russin, DONPI 1407852049

Title

Owner

Phone

(610) 617-4177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Simon R Russin, DO

  • Ophthalmology Physician
  • Bala Cynwyd, PA
  • NPI 1407852049
  Authorized official Same address or phone

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1720255508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CITY AVENUE",
            "address_2": "SUITE 335",
            "city": "BALA CYNWOOD",
            "state": "PA",
            "postal_code": "19004",
            "telephone_number": "610-617-4177",
            "fax_number": "610-617-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CITY AVENUE",
            "address_2": "SUITE 335",
            "city": "BALA CYNWOOD",
            "state": "PA",
            "postal_code": "19004",
            "telephone_number": "610-617-4177",
            "fax_number": "610-617-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSIN EYE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "RUSSIN",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-617-4177",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "OS009908L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001697374",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Najneen Ahmed, O.D.
• Celeste C Mruk, MD
• Ruth Sampson-Pilgrim

• Ophthalmology Physician in Bala Cynwood, PA
• Providers in Bala Cynwood, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.