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Individual

GRETCHEN BREWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
2329 COTTMAN AVE, ROSSEVELT MALL, PHILADELPHIA, PA 19149
(215) 332-7228
(215) 332-9337
Mailing address
2329 COTTMAN AVE, ROOSEVELT MALL, PHILADELPHIA, PA 19149
(215) 332-7228
(215) 332-9337

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000944
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01975373
PA
01
1345378
PERSONAL CHOICE BLUE CHOI
PA
01
2037984000
KEYSTONE HEALTHPLAN EAST
PW
01
7377317
AETNA
PA
01
BR1345378
BCBS PA BLUE SHIELD
PA
Enumeration date
10/06/2006
Last updated
07/08/2007
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