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General NPI Number Information
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NPI Number | 1346254109
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Entity Type | Organization
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Legal Business Name | WEST PHILADELPHIA EYE ASSOCIATES INC.
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 09/20/2013
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Provider Practice Location Address
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Address Line | 501 S 54TH ST SUITE 25
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1900
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Country | US
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Telephone | 215-748-0185
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Fax | 215-748-0180
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Provider Business Mailing Address
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Address Line | 501 S 54TH ST SUITE 25
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City | PHILADELPHIA
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State | PA
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Zip | 19143-1900
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Country | US
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Telephone | 215-748-0185
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Fax | 215-748-0180
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Authorized Official
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Title or Position | PRESIDENT
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Name | PROF. ANGELO J JONES
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Credential | OWNER
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Telephone | 215-748-0185
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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 |
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License Number State |
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