Individual
MARK MARGOLIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
29 STONYBROOK DR, LEVITTOWN, PA 19055-2216
(215) 946-1221
(215) 946-1225
Mailing address
1724 KENDRICK ST, PHILADELPHIA, PA 19152-1816
(215) 946-1221
(215) 946-1225
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000972
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000972
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001607401
—
PA
01
—
410024019
RAILROAD MEDICARE PROVIDER NUMBER/PTAN
PA
Enumeration date
06/27/2005
Last updated
06/30/2010
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