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Individual

SUSAN E. EDMONDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
3300 TOWNSHIP LINE RD, SUITE 101, DREXEL HILL, PA 19026-1925
(610) 449-2540
(610) 449-2751
Mailing address
3300 TOWNSHIP LINE RD, SUITE 101, DREXEL HILL, PA 19026-1925
(610) 449-2540
(610) 449-2751

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000493
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000493
PA
152WL0500X
Low Vision Rehabilitation Optometrist
OEG000493
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0033165000
KEYSTONE
PA
01
2545643
AETNA
PA
01
429782
BLUE CROSS/ BLUE SHIELD
PA
Enumeration date
05/31/2006
Last updated
10/10/2008
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