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General NPI Number Information
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NPI Number | 1861611766
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Entity Type | Organization
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Legal Business Name | STEPHEN F. HERSH, O.D., P.C.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2604 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1301
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Country | US
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Telephone | 215-331-0630
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Fax |
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Provider Business Mailing Address
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Address Line | 2604 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1301
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Country | US
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Telephone | 215-331-0630
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN F. HERSH
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Credential | O.D.
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Telephone | 215-331-0630
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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 | OEP008549
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License Number State | PA
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