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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