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Organization

KRYSTAL VISION CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KRYSTAL T NGUYEN O.D. (PRESIDENT)
(215) 744-6727
Entity
Organization

Contact information

Practice address
6533 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2918
(215) 744-6727
Mailing address
6533 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2918
(215) 744-6727
(215) 744-1622

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000225
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AETNA
3548372
PA
01
HIGHMARK
1626663
PA
01
IBC
2308658000
PA
Enumeration date
07/04/2006
Last updated
03/03/2011
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