Healthcare Provider Details

I. General information

NPI: 1750355715
Provider Name (Legal Business Name): OPHTHALMIC PARTNERS OF DELAWARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 SILVERSIDE RD
WILMINGTON DE
19810-4910
US

IV. Provider business mailing address

40 MONUMENT RD STE 104
BALA CYNWYD PA
19004-1700
US

V. Phone/Fax

Practice location:
  • Phone: 302-479-3937
  • Fax: 302-454-8810
Mailing address:
  • Phone: 610-660-0446
  • Fax: 484-434-2793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIA LEE
Title or Position: EXECUTIVE DIRECTOR
Credential: JD
Phone: 610-660-0446