Healthcare Provider Details

I. General information

NPI: 1083814271
Provider Name (Legal Business Name): RETINA AND VITREOUS OF DELAWARE COUNTY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 BALTIMORE PIKE #304
SPRINGFIELD PA
19064-3810
US

IV. Provider business mailing address

491 BALTIMORE PIKE #304
SPRINGFIELD PA
19064-3810
US

V. Phone/Fax

Practice location:
  • Phone: 855-250-3937
  • Fax:
Mailing address:
  • Phone: 855-250-3937
  • Fax:

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. WILLIAM JOSEPH FOSTER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 713-203-3573