Individual
CATHY MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1523 WALNUT ST, PHILADELPHIA, PA 19102-3001
(215) 845-0987
Mailing address
1523 WALNUT ST, PHILADELPHIA, PA 19102-3001
(215) 845-0987
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003505
PA
152W00000X
Optometrist
TUV008900-1
NY
Other
Enumeration date
11/08/2018
Last updated
12/24/2019
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