Healthcare Provider Details

I. General information

NPI: 1003854613
Provider Name (Legal Business Name): VIVIAN DESCANT OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 N 5TH ST
PERKASIE PA
18944-1868
US

IV. Provider business mailing address

1139 N 5TH ST
PERKASIE PA
18944-1868
US

V. Phone/Fax

Practice location:
  • Phone: 215-257-3937
  • Fax: 215-257-4251
Mailing address:
  • Phone: 215-257-3937
  • Fax: 215-257-4251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG 000635
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: