Healthcare Provider Details

I. General information

NPI: 1548438518
Provider Name (Legal Business Name): OCULAR TELEHEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 9TH ST
PHILADELPHIA PA
19107-6810
US

IV. Provider business mailing address

1651 W FRONT ST PO BOX 468
BERWICK PA
18603-4202
US

V. Phone/Fax

Practice location:
  • Phone: 610-955-5995
  • Fax: 610-956-0009
Mailing address:
  • Phone: 610-956-0003
  • Fax: 610-956-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JAY L FEDERMAN
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 610-955-5995