Individual
CAROLYN S REPKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1930 S BROAD ST UNIT 9, PHILADELPHIA, PA 19145-2328
(215) 339-8100
(215) 339-8103
Mailing address
1930 S BROAD ST UNIT 9, PHILADELPHIA, PA 19145-2328
(215) 339-8100
(215) 339-8103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
25MA06190700
NJ
207W00000X
Ophthalmology Physician
Primary
MD051481L
PA
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
MD051481L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0161265
—
PA
Enumeration date
08/09/2005
Last updated
01/13/2020
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