Individual
ROBERT S SUSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
523 KIMBERTON RD, SUITE 11C, PHOENIXVILLE, PA 19460-4745
(610) 933-2177
(610) 933-8782
Mailing address
523 KIMBERTON RD, SUITE 11C, PHOENIXVILLE, PA 19460-4745
(610) 933-2177
(610) 933-8782
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0E008279T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00175534200001
—
PA
Enumeration date
06/21/2006
Last updated
03/11/2014
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