Organization
PREMIERVISION LASER CENTER, INC.
Active
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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