Healthcare Provider Details

I. General information

NPI: 1982477006
Provider Name (Legal Business Name): CHESTNUT HILL EYE ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 07/03/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 E HIGHLAND AVE
PHILADELPHIA PA
19118-3308
US

IV. Provider business mailing address

12 E HIGHLAND AVE
PHILADELPHIA PA
19118
US

V. Phone/Fax

Practice location:
  • Phone: 267-297-7723
  • Fax: 267-277-7790
Mailing address:
  • Phone: 267-297-7723
  • Fax: 267-277-7790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: IRENE MUSTEN
Title or Position: OWNER
Credential: OD
Phone: 267-297-7723