MEDICARE: DR. YASMIN VESAMIA OD

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	OEG002611	PA

General Provider Information

NPI Number	:	1134474299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YASMIN VESAMIA OD

Provider Business Mailing Address
First Line	:	8480 LIMEKILN PIKE
Second Line	:	APARTMENT 320
City	:	WYNCOTE
State	:	PA
Zip	:	19095-2801
Country	:	US
Telephone Number	:	407-443-8056
Fax Number	:

Provider Business Practice Location Address
First Line	:	2118 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1133
Country	:	US
Telephone Number	:	215-725-1209
Fax Number	:

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

Provider Enumeration Date	:	07/16/2012
Last Update Date	:	07/16/2012

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