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General NPI Number Information
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NPI Number | 1588191985
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Entity Type | Individual
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Provider Name | NICHOLAS JAMES KARBACH OD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 1200 W GODFREY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19141
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Country | US
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Telephone | 215-276-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 CONSHOHOCKEN AVE APT 9203
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City | PHILADELPHIA
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State | PA
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Zip | 19131-5441
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Country | US
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Telephone | 540-819-0491
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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 | OEG003319
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License Number State | PA
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