Organization
R. DOUGLAS QUAY, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R DOUGLAS QUAY O.D. (OWNER)
(610) 432-3866
Entity
Organization
Contact information
Practice address
2030 W TILGHMAN ST, ALLENTOWN, PA 18104-4354
(610) 432-3258
(610) 289-2100
Mailing address
2030 W TILGHMAN ST, ALLENTOWN, PA 18104-4354
(610) 432-3258
(610) 289-2100
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OE-T008757
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000020068
HIGHMARK BLUE SHIELD
PA
01
—
0003330
AETNA
PA
01
—
000764617
BLUE SHIELD GROUP NUMBER
PA
01
—
01395401
BLUE CROOS
PA
01
—
0201390001
MEDICARE DMERC
PA
01
—
02419600
BLUE CROSS GROUP NUMBER
PA
01
—
029277
MEDICARE GROUP NUMBER
PA
01
—
410004225
RAIL ROAD MEDICARE
PA
01
—
OE-T008757
LICENSE NUMBER
PA
Enumeration date
02/19/2008
Last updated
09/22/2010
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