MEDICARE: NORTHERN OPHTHALMIC 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1528656097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN OPHTHALMIC ASSOCIATES

Provider Business Mailing Address
First Line	:	500 YORK RD STE 102
Second Line	:
City	:	JENKINTOWN
State	:	PA
Zip	:	19046-2871
Country	:	US
Telephone Number	:	215-885-6830
Fax Number	:

Provider Business Practice Location Address
First Line	:	9880 BUSTLETON AVE STE 313
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-2144
Country	:	US
Telephone Number	:	215-677-9762
Fax Number	:	215-677-6790

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	MARK F. PYFER
Credential	:	MD
Telephone Number	:	215-885-6830

Provider Enumeration Date	:	01/09/2021
Last Update Date	:	01/09/2021

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