MEDICARE: MATTHEW HASSEY 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	OEG003048	PA

General Provider Information

NPI Number	:	1619350220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW HASSEY O,D.

Provider Business Mailing Address
First Line	:	8215 PINE RD
Second Line	:	APARTMENT B1
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-1872
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2118 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1133
Country	:	US
Telephone Number	:	800-609-1183
Fax Number	:

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

Provider Enumeration Date	:	06/30/2015
Last Update Date	:	06/30/2015

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