Organization
OPHTHALMOLOGY CTR. , LTD.
Active
Other names
Haddonfield Eye Association
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAIL MUSSOLINE (OFFICE SUPERVISOR)
(856) 429-2199
Entity
Organization
Contact information
Practice address
1637 S BROAD ST, PHILADELPHIA, PA 19148-1003
(215) 465-7100
(215) 463-3550
Mailing address
1637 S BROAD ST, PHILADELPHIA, PA 19148-1003
(215) 465-7100
(215) 463-3550
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0114330000
AMERIHEALTH
NJ
01
—
55507
US HEALTHCARE
NJ
Enumeration date
05/22/2006
Last updated
02/06/2013
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