Healthcare Provider Details

I. General information

NPI: 1225964182
Provider Name (Legal Business Name): JULIANA HADDAD OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 W TILGHMAN ST STE 101
ALLENTOWN PA
18104-4354
US

IV. Provider business mailing address

2030 W TILGHMAN ST STE 101
ALLENTOWN PA
18104-4354
US

V. Phone/Fax

Practice location:
  • Phone: 610-432-3258
  • Fax:
Mailing address:
  • Phone: 610-432-3258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG004405
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: