Organization
FARYAL AZAM OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARYAL AZAM O.D (OPTOMETRIST)
(267) 241-8006
Entity
Organization
Contact information
Practice address
9475 ROOSEVELT BLVD, INSIDE PEARLE VISION, PHILADELPHIA, PA 19114-2212
(215) 698-7600
Mailing address
9475 ROOSEVELT BLVD, INSIDE PEARLE VISION, PHILADELPHIA, PA 19114-2212
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002637
PA
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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