Provider Demographics
NPI:1447455126
Name:EYE CARE ASSOCIATES NW PA
Entity type:Organization
Organization Name:EYE CARE ASSOCIATES NW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-404-6037
Mailing Address - Street 1:11 WOODFIELD CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-4639
Mailing Address - Country:US
Mailing Address - Phone:410-404-6037
Mailing Address - Fax:
Practice Address - Street 1:3400 BARRY PAUL RD
Practice Address - Street 2:SUITE 4
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5161
Practice Address - Country:US
Practice Address - Phone:419-655-8114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022624207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD171LMedicare ID - Type Unspecified