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General NPI Number Information
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NPI Number | 1750610309
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Entity Type | Organization
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Legal Business Name | CENTRAL CITY EYECARE, LLC
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Dates
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Enumeration Date | 12/10/2009
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 105 N 9TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-2410
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Country | US
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Telephone | 215-873-0340
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Fax | 215-873-0343
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Provider Business Mailing Address
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Address Line | 105 N 9TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-2410
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Country | US
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Telephone | 215-873-0340
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Fax | 215-873-0343
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. MIN XU
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Credential |
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Telephone | 215-873-0340
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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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