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General NPI Number Information
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NPI Number | 1619350220
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Entity Type | Individual
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Provider Name | MATTHEW HASSEY O,D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 2118 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1133
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Country | US
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Telephone | 800-609-1183
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Fax |
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Provider Business Mailing Address
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Address Line | 8215 PINE RD APARTMENT B1
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City | PHILADELPHIA
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State | PA
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Zip | 19111-1872
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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 |
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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 | OEG003048
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License Number State | PA
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