MEDICARE: DR. PRARTHANA AGRAWAL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG002799	PA
2	152W00000X	Optometrist	27OA00695400	NJ
3	152W00000X	Optometrist	011164	NY
4	152W00000X	Optometrist	ODP-100637	ID
5	152W00000X	Optometrist	10724T	TX

General Provider Information

NPI Number	:	1013355288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRARTHANA AGRAWAL O.D.

Provider Business Mailing Address
First Line	:	5500 WISSAHICKON AVE
Second Line	:	APT M111C
City	:	PHILADELPHIA
State	:	PA
Zip	:	19144-5653
Country	:	US
Telephone Number	:	215-200-9536
Fax Number	:

Provider Business Practice Location Address
First Line	:	690 W DEKALB PIKE
Second Line	:	LENSCRAFTERS
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-2943
Country	:	US
Telephone Number	:	610-337-4114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2013
Last Update Date	:	12/16/2025

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