MEDICARE: MEGAN BULIANO SMITH 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	OEG001626	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598739567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN BULIANO SMITH O.D.

Provider Business Mailing Address
First Line	:	30 MEDICAL CENTER BLVD STE 104
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-3955
Country	:	US
Telephone Number	:	610-874-5261
Fax Number	:	610-874-0318

Provider Business Practice Location Address
First Line	:	30 MEDICAL CENTER BLVD STE 104
Second Line	:
City	:	CHESTER
State	:	PA
Zip	:	19013-3955
Country	:	US
Telephone Number	:	610-874-5261
Fax Number	:	610-874-0318

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	11/01/2020

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