Organization
NEURO-OPHTHALMOLOGIC ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CHARLES SERGOTT MD (PRESIDENT)
(215) 928-3130
Entity
Organization
Contact information
Practice address
840 WALNUT ST, SUITE 930, PHILADELPHIA, PA 19107-5109
(215) 928-3130
(215) 592-1923
Mailing address
840 WALNUT ST, SUITE 930, PHILADELPHIA, PA 19107-5109
(215) 928-3130
(215) 592-1923
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD031030L
PA
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000252102
—
DE
05
—
000688737
—
PA
01
—
0060163000
INDEPENDENCE BLUE CROSS
—
01
—
039391
HIGHMARK BLUE SHIELD
PA
05
—
3528804
—
NJ
Enumeration date
07/19/2005
Last updated
06/15/2017
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