CT Eyecare LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

CT EYECARE LLC

Practice address

305 S 60TH St
Philadelphia, PA 19143-1101

Phone

(215) 474-1390

NPI assigned

Feb 5, 2009

Last updated

Feb 5, 2009By 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

Mr. Ayodale Castillo Tan

Title

President

Phone

(215) 834-2965

Specialties & licenses 1

Addresses

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.

• Imelda Castillo Tan, O.D.

  • Optometrist
  • Philadelphia, PA
  • NPI 1093883340
  NPD (past)

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1861631475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S 60TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S 60TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431101",
            "telephone_number": "215-474-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-05",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "AYODALE",
        "authorized_official_middle_name": "CASTILLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-834-2965",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Point of Service in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.