Organization
PREMIERVISION LASER CENTER, INC.
Active
Other names
Cordelia N. Uddoh, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORDELIA NKOLIKA UDDOH MD (PRESIDENT)
(215) 657-5044
Entity
Organization
Contact information
Practice address
3212 W CHELTENHAM AVE, PHILADELPHIA, PA 19150-1003
(215) 657-5044
(215) 657-5046
Mailing address
PO BOX 539, WILLOW GROVE, PA 19090-0539
(215) 657-5044
(215) 657-5046
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD069007L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012162880001
—
PA
01
—
187975
MEDICARE-PTAN
—
Enumeration date
12/04/2006
Last updated
07/30/2020
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