MEDICARE: MARK H BLECHER MD

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	207W00000X	Ophthalmology Physician	MD029459E	PA
2	207W00000X	Ophthalmology Physician	25MA05273000	NJ

General Provider Information

NPI Number	:	1356343248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK H BLECHER MD

Provider Business Mailing Address
First Line	:	1703 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1536
Country	:	US
Telephone Number	:	215-339-8100
Fax Number	:	215-339-8103

Provider Business Practice Location Address
First Line	:	1703 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1536
Country	:	US
Telephone Number	:	215-339-8100
Fax Number	:	215-339-8103

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	03/10/2017

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