Organization
WEST PHILADELPHIA EYE ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAT D DUONG D.O. (DOCTOR)
(215) 748-0185
Entity
Organization
Contact information
Practice address
501 S 54TH ST, SUITE 25, PHILADELPHIA, PA 19143-1900
(215) 748-0185
(215) 748-0180
Mailing address
501 S 54TH ST, SUITE 25, PHILADELPHIA, PA 19143-1900
(215) 748-0185
(215) 748-0180
Taxonomy
Speciality
Code
Description
License number
State
152WX0102X
Occupational Vision Optometrist
Primary
OEG000507
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1435485
PERSONAL CHOICE/BLUE CHOI
PA
01
—
2119844000
KEYSTONE HEALTH PLAN EAST
PA
Enumeration date
07/18/2006
Last updated
08/22/2020
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