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Contact Information

BROOKHAVEN FAMILY EYE CARE CENTER
4106 EDGMONT AVE
BROOKHAVEN, PA19015-2314
 Phone: 610-872-8989
 Fax: 610-872-5220
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for BROOKHAVEN FAMILY EYE CARE CENTER

NPI Number 1760490494
LBN Legal business name BROOKHAVEN FAMILY EYE CARE CENTER
Authorized official MICAELA SMALL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/05/2006
Last updated 05/14/2024 - About 2 years ago
Identifiers
PA License # OEG001547
PA Other 2628516 AETNA GROUP HMO
PA Other 5498366 AETNA UNIVERSAL GROUP
PA Other 001429488 HIGHMARK
PA Other 2115330000 INDEPENDENCE BLUE CROSS
PA Other CM9120 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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