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General NPI Number Information
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NPI Number | 1518177393
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Entity Type | Organization
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Legal Business Name | TWENTYTWENTYHEALTHCARE
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 512 MONTGOMERY AVE
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City | HAVERFORD
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State | PA
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Zip | 19041-1409
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Country | US
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Telephone | 610-506-3114
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Fax | 610-642-0941
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Provider Business Mailing Address
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Address Line | 512 MONTGOMERY AVE
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City | HAVERFORD
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State | PA
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Zip | 19041-1409
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Country | US
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Telephone | 610-506-3114
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Fax | 610-642-0941
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Authorized Official
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Title or Position | MEMBER
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Name | DORAY IBRAHIM GURKAYNAK
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Credential | OD
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Telephone | 610-506-3114
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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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