Provider Demographics
NPI:1043610967
Name:SHIRLEY EYE CARE LLC
Entity type:Organization
Organization Name:SHIRLEY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-859-3378
Mailing Address - Street 1:241 RUSTIC LODGE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3472
Mailing Address - Country:US
Mailing Address - Phone:724-463-8882
Mailing Address - Fax:724-465-8550
Practice Address - Street 1:241 RUSTIC LODGE RD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3472
Practice Address - Country:US
Practice Address - Phone:724-463-8882
Practice Address - Fax:724-465-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002899152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty