Individual
MISS GELENA BANIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
11685 BUSTLETON AVE, PHILADELPHIA, PA 19116-2542
(917) 449-5033
Mailing address
73 BRUCE DR, HOLLAND, PA 18966-2179
(215) 350-1444
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001002
PA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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