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General NPI Number Information
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NPI Number | 1972987279
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Entity Type | Individual
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Provider Name | KATHRYN ELIZABETH CLARE OD
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Gender | Female
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 3400 CIVIC CENTER BLVD WEST PAVILION, 3RD FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19104-5127
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Country | US
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Telephone | 215-614-4100
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Fax | 215-615-0527
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Provider Business Mailing Address
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Address Line | 51 NORTH 39TH STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19104-2689
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Country | US
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Telephone | 215-614-4100
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Fax | 215-615-0527
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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 | 27OA00703400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OEG003088
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | OEG003088
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | OEG003088
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003088
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License Number State | PA
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