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Organization

SUBURBAN EYE CARE OPTOMETRIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN J BURRELL OD (OWNER)
(610) 631-1142
Entity
Organization

Contact information

Practice address
10 CLEARFIELD AVE, TROOPER, PA 19403-1655
(610) 631-1142
Mailing address
10 CLEARFIELD AVE, TROOPER, PA 19403-1655
(610) 631-1142

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000682
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
113996
BLUE SHIELD NJ
NJ
01
113996
AETNA
01
139725
OXFORD
01
2116909000
KEYSTONE
01
94012
AETNA HMO
01
SU507539
AMERICHOICE
PA
Enumeration date
03/29/2007
Last updated
08/22/2020
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