Healthcare Provider Details

I. General information

NPI: 1558360123
Provider Name (Legal Business Name): SOLL EYE PC OF PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 FRANKFORD AVE
PHILADELPHIA PA
19124-2619
US

IV. Provider business mailing address

5001 FRANKFORD AVE
PHILADELPHIA PA
19124-2619
US

V. Phone/Fax

Practice location:
  • Phone: 215-288-5000
  • Fax: 215-744-1233
Mailing address:
  • Phone: 215-288-5000
  • Fax: 215-744-1233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN M SOLL
Title or Position: MD
Credential: MD
Phone: 215-288-5000