MEDICARE: SANA TAHIR 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
1	152W00000X	Optometrist	OEG003372	PA

General Provider Information

NPI Number	:	1952815375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANA TAHIR OD

Provider Business Mailing Address
First Line	:	2214 BORBECK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3724
Country	:	US
Telephone Number	:	267-205-8281
Fax Number	:

Provider Business Practice Location Address
First Line	:	2214 BORBECK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3724
Country	:	US
Telephone Number	:	267-205-8281
Fax Number	:

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

Provider Enumeration Date	:	11/21/2017
Last Update Date	:	11/21/2017

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