MEDICARE: STEPHEN F. HERSH, O.D., P.C.

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	OEP008549	PA

General Provider Information

NPI Number	:	1861611766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN F. HERSH, O.D., P.C.

Provider Business Mailing Address
First Line	:	2604 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1301
Country	:	US
Telephone Number	:	215-331-0630
Fax Number	:

Provider Business Practice Location Address
First Line	:	2604 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19149-1301
Country	:	US
Telephone Number	:	215-331-0630
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN F. HERSH
Credential	:	O.D.
Telephone Number	:	215-331-0630

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

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