Individual
ELISA BANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5001 FRANKFORD AVE, PHILADELPHIA, PA 19124-2619
(215) 288-5000
(215) 744-1233
Mailing address
5001 FRANKFORD AVE, PHILADELPHIA, PA 19124-2619
(215) 288-5000
(215) 744-1233
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00851100
NJ
152W00000X
Optometrist
OEG002681
PA
183700000X
Pharmacy Technician
5793
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OEG002681
LICENSE
PA
Enumeration date
03/30/2007
Last updated
07/21/2022
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