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General NPI Number Information
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NPI Number | 1538761382
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Entity Type | Organization
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Legal Business Name | OPHTHALMIC PARTNERS PC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 775 ROUTE 70 E STE F180
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City | MARLTON
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State | NJ
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Zip | 08053-2367
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Country | US
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Telephone | 856-596-1601
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Fax | 856-983-0396
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Provider Business Mailing Address
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Address Line | 100 PRESIDENTIAL BLVD STE 200
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1108
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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 | ADMINISTRATOR
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Name | NANCY BAKER
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Credential |
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Telephone | 484-434-2784
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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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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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