MEDICARE: PENNSYLVANIA OPTOMETRICS INC.

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	DEG000891	PA

General Provider Information

NPI Number	:	1851305361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENNSYLVANIA OPTOMETRICS INC.

Provider Business Mailing Address
First Line	:	3600 MARKET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2641
Country	:	US
Telephone Number	:	215-387-3600
Fax Number	:	215-387-4784

Provider Business Practice Location Address
First Line	:	3600 MARKET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2641
Country	:	US
Telephone Number	:	215-387-3600
Fax Number	:	215-387-4784

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN MARK GALANTER
Credential	:	O.D.
Telephone Number	:	215-387-3600

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	08/22/2020

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