Individual
DR. GWENN AMOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6000
(215) 276-1329
Mailing address
43 HENDRICKS ST, AMBLER, PA 19002-4433
(215) 654-9718
(215) 276-1329
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001350
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00091343
RAILROAD MEDICARE
PA
01
—
0321825000
KHPE
PA
01
—
1762595
BLUE SHIELD
PA
01
—
2248
AETNA HMO
PA
Enumeration date
10/04/2006
Last updated
02/15/2012
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