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NPI Code Detail

MEDICARE: PHILADELPHIA EYE ASSOCIATES

MEDICARE: PHILADELPHIA EYE ASSOCIATES
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1386718732
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILADELPHIA EYE ASSOCIATES
Provider Business Mailing Address
First Line : 2610 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-5104
Country : US
Telephone Number : 215-423-5154
Fax Number : 215-423-4682
Provider Business Practice Location Address
First Line : 2610 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-5104
Country : US
Telephone Number : 215-423-5154
Fax Number : 215-423-4682
Authorized Official
Title or Position : PRESIDENT
Name : DR. MARC DAVID GARDEN
Credential : MD
Telephone Number : 215-423-5154
Provider Enumeration Date : 11/20/2006
Last Update Date : 08/22/2020

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Directions to “PHILADELPHIA EYE ASSOCIATES ” Practice Location

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