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General NPI Number Information
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NPI Number | 1063865053
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Entity Type | Organization
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Legal Business Name | GP EYECARE SPECIALISTS
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 3461 HORIZON BLVD
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City | TREVOSE
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State | PA
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Zip | 19053-4967
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Country | US
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Telephone | 215-942-7671
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Fax | 215-942-7673
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Provider Business Mailing Address
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Address Line | 3461 HORIZON BLVD
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City | TREVOSE
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State | PA
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Zip | 19053-4967
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Country | US
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Telephone | 215-942-7671
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Fax | 215-942-7673
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Authorized Official
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Title or Position | OPTOMETRIST/CO-OWNER
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Name | HELEN LUU
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Credential | O.D.
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Telephone | 215-488-9030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG002790
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG002493
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License Number State | PA
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