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Individual

MR. AZAD ABULKALAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 MAIN ST STE 110, KING OF PRUSSIA, PA 19406-1385
(201) 705-9122
Mailing address
100 MAIN ST STE 110, KING OF PRUSSIA, PA 19406-1385
(201) 705-9122

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9999999
PA

Other

Enumeration date
01/15/2019
Last updated
01/15/2019
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