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General NPI Number Information
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NPI Number | 1497959456
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Entity Type | Individual
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Provider Name | LAVERDA MONIQUE RICHARDS O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 3212 W CHELTENHAM AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1003
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Country | US
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Telephone | 215-885-1200
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Fax | 215-885-8807
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Provider Business Mailing Address
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Address Line | 1316 W CHESTER PIKE APT C7
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City | WEST CHESTER
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State | PA
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Zip | 19382-6435
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Country | US
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Telephone | 610-761-4760
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Fax |
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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 | 13-0001387
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License Number State | DE
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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 | OL-049
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License Number State | GU
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OE008223T
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License Number State | PA
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