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General NPI Number Information
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NPI Number | 1093984239
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Entity Type | Organization
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Legal Business Name | SILIQUINI OPTICAL
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 2818 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1419
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Country | US
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Telephone | 215-331-8458
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Fax |
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Provider Business Mailing Address
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Address Line | 2818 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1419
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN SILIQUINI JR.
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Credential |
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Telephone | 215-331-8458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number | MD060688L
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License Number State | PA
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