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NPI Code Detail

MEDICARE: JULLIETTE MENSAH OD

MEDICARE: JULLIETTE MENSAH OD
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
1152W00000XOptometristOEG004343PA

General Provider Information

NPI Number : 1710875745
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULLIETTE MENSAH OD
Provider Business Mailing Address
First Line : 1200 W GODFREY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-3323
Country : US
Telephone Number : 215-276-6000
Fax Number : 215-276-1329
Provider Business Practice Location Address
First Line : 1200 W GODFREY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-3323
Country : US
Telephone Number : 215-276-6000
Fax Number : 215-276-1329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2025
Last Update Date : 03/10/2026

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Directions to “ JULLIETTE MENSAH OD” Practice Location

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