=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699870907
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHARD E KAREHA OD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2006
-----------------------------------------------------
Last Update Date | 02/13/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8601 WEST CHESTER PIKE
-----------------------------------------------------
City | UPPER DARBY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-446-4442
-----------------------------------------------------
Fax | 610-446-7142
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 353 N 3RD STREET
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19363
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-998-9800
-----------------------------------------------------
Fax | 610-998-9109
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 5660
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------