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General NPI Number Information
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NPI Number | 1326109547
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Entity Type | Individual
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Provider Name | PAUL H ROBERTS OD.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 10/15/2013
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Provider Practice Location Address
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Address Line | 1348 W ERIE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4254
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Country | US
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Telephone | 215-223-5000
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Fax | 215-223-9180
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Provider Business Mailing Address
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Address Line | 1348 W ERIE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4254
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Country | US
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Telephone | 215-223-5000
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Fax | 215-223-9180
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0EG001404
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License Number State | PA
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