MEDICARE: DR. DELBERT C RITCHEY JR. 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	OEG000741	PA

General Provider Information

NPI Number	:	1194878520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DELBERT C RITCHEY JR. O.D.

Provider Business Mailing Address
First Line	:	1528 WALNUT ST
Second Line	:	PEARLE VISION
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3604
Country	:	US
Telephone Number	:	215-732-7622
Fax Number	:	215-732-7626

Provider Business Practice Location Address
First Line	:	1528 WALNUT ST
Second Line	:	PEARLE VISION
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3604
Country	:	US
Telephone Number	:	215-732-7622
Fax Number	:	215-732-7626

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	06/08/2016

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