Organization
PHOENIX EYE CARE INC
Active
Organization
PHOENIX EYE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TING LI OD (PRESIDENT)
(216) 741-6786
Entity
Organization
Contact information
Practice address
10000 BROOKPARK RD, CLEVELAND, OH 44130-1102
(216) 741-6786
Mailing address
10000 BROOKPARK RD, CLEVELAND, OH 44130-1102
(216) 741-6786
(216) 741-6653
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5799/T2713
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346405487
PERSONAL NPI
—
05
—
3041658
—
OH
01
—
3137279
MEDICAID GROUP NUMBER
OH
01
—
4281341
MEDICARE PROVIDER NUMBER
—
Enumeration date
11/03/2010
Last updated
03/04/2024
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