Organization
CLASSIC OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AYODALE CASTILLO TAN (VICE PRESIDENT)
(215) 722-2242
Entity
Organization
Contact information
Practice address
6516 RISING SUN AVE, PHILADELPHIA, PA 19111-5245
(215) 722-2242
(215) 722-6544
Mailing address
6516 RISING SUN AVE, PHILADELPHIA, PA 19111-5245
(215) 722-2242
(215) 722-6544
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
01/29/2013
Last updated
10/22/2013
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