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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