MEDICARE: DR. AMALIA CATHERINE BURRELL OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG003817	PA

General Provider Information

NPI Number	:	1821660572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMALIA CATHERINE BURRELL OD

Provider Business Mailing Address
First Line	:	10 CLEARFIELD AVE
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-1655
Country	:	US
Telephone Number	:	610-631-1142
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 CLEARFIELD AVE
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-1655
Country	:	US
Telephone Number	:	610-631-1142
Fax Number	:	610-631-2038

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	07/13/2021

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