Provider Demographics
NPI:1861716839
Name:EYES ON SENIORS
Entity type:Organization
Organization Name:EYES ON SENIORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VAN ANH
Authorized Official - Middle Name:THI
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-299-4431
Mailing Address - Street 1:363 CREEKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-6811
Mailing Address - Country:US
Mailing Address - Phone:610-299-4431
Mailing Address - Fax:
Practice Address - Street 1:363 CREEKSIDE LN
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-6811
Practice Address - Country:US
Practice Address - Phone:610-299-4431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001439152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88679Medicare UPIN