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Individual

IMELDA CASTILLO TAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3166 KENSINGTON AVE, PHILADELPHIA, PA 19134-2421
(215) 425-3937
(215) 739-3661
Mailing address
7901 ROCKWELL AVENUE, PHILADELPHIA, PA 19111-2222
(215) 342-0392
(215) 739-3661

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000945
PA

Other

Enumeration date
12/02/2006
Last updated
07/24/2013
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