Organization
UNIV OF PENN-SCHEIE EYE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
(215) 662-7583
Entity
Organization
Contact information
Practice address
3400 SPRUCE ST, 2 GATES, PHILADELPHIA, PA 19104-4206
(215) 662-3203
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
PA
2084N0400X
Neurology Physician
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002Y20015
HEALTHNET
PA
01
—
003572
AETNA
PA
01
—
0053124000
KEYSTONE
PA
01
—
037963
BLUE SHIELD
PA
01
—
1003317
MERCY
PA
05
—
1007330580
—
PA
01
—
10383
HEALTHPARTNERS
PA
01
—
203635
EEIOC
PA
01
—
273498
MAMSI
PA
01
—
6027709
NJ-MEDICAID
NJ
01
—
CD4568
RR MEDICARE
PA
01
—
G00050820
AMERICHOICE
PA
Enumeration date
08/16/2006
Last updated
01/06/2014
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