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General NPI Number Information
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NPI Number | 1871608596
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Entity Type | Organization
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Legal Business Name | IRVING I CRIDEN & SCOTT PAGE OD PC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 1015 CHESTNUT ST SUITE 417
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4316
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Country | US
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Telephone | 215-627-4448
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Fax | 215-627-5798
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Provider Business Mailing Address
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Address Line | 1015 CHESTNUT ST SUITE 417
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4316
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Country | US
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Telephone | 215-627-4448
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Fax | 215-627-5798
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KIM SYLVESTER
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Credential |
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Telephone | 215-627-4448
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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 | OEG001654
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License Number State | PA
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