Basic Information
| Provider Information | |||||||||
| NPI: | 1730143488 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GLASSES GALORE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2842 S EAGLE RD | ||||||||
| Address2: | |||||||||
| City: | NEWTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189401543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155791155 | ||||||||
| FaxNumber: | 2155048076 | ||||||||
| Practice Location | |||||||||
| Address1: | 2842 S EAGLE RD | ||||||||
| Address2: | |||||||||
| City: | NEWTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189401543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155791155 | ||||||||
| FaxNumber: | 2155048076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BALTER | ||||||||
| AuthorizedOfficialFirstName: | JASON | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2155791155 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.