MEDICARE: MODERN OPTOMETRY, INC.

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	OEG000070	PA

General Provider Information

NPI Number	:	1497144083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODERN OPTOMETRY, INC.

Provider Business Mailing Address
First Line	:	3300 GRANT AVE STE 21
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-2632
Country	:	US
Telephone Number	:	215-335-9090
Fax Number	:	215-333-5225

Provider Business Practice Location Address
First Line	:	3300 GRANT AVE STE 21
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-2632
Country	:	US
Telephone Number	:	215-335-9090
Fax Number	:	215-333-5225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. REBECCA VERNA
Credential	:	O.D.
Telephone Number	:	610-662-4855

Provider Enumeration Date	:	01/20/2015
Last Update Date	:	10/19/2021

Similar Medicare Providers

1821290792 — DR. REBECCA VERNA O.D.
Practice Location Address:

3300 GRANT AVE STE 21
PHILADELPHIA, PA
19114-2632

Practice Phone: 215-335-9090
Practice Fax: 215-333-5225

1578092219 — BRIAN P KANE PTA
Practice Location Address:

3300 GRANT AVE STE 20
PHILADELPHIA, PA
19114-2632

Practice Phone: 215-647-9601
Practice Fax:

1033856869 — JOSE ANGELO GRACIA NIEDO PT
Practice Location Address:

3300 GRANT AVE STE 20
PHILADELPHIA, PA
19114-2632

Practice Phone: 877-444-2422
Practice Fax:

1275409427 — DR. SAMANTHA JANE RILEY DC
Practice Location Address:

3300 GRANT AVE STE 20
PHILADELPHIA, PA
19114-2632

Practice Phone: 888-245-8488
Practice Fax:

1184625865 — OLIVER C. BULLOCK DO
Practice Location Address:

2100 W CAMBRIA ST
PHILADELPHIA, PA
19132-2632

Practice Phone: 215-578-3300
Practice Fax: 215-578-3335

1629070644 — JENNIFER PRESCOTT-CORAGGIO DO
Practice Location Address:

2100 W CAMBRIA ST
PHILADELPHIA, PA
19132-2632

Practice Phone: 215-578-3300
Practice Fax: 215-578-3335

Directions to “MODERN OPTOMETRY, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.