Moore, Sandra M
Moore, Sandra M is an individual health care provider with primary practice located at 2139 Cottman Ave , Philadelphia PA 19149-1122. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Moore, Sandra M can be contacted via phone (215) 745-1444.Contact Information
Primary practice address
2139 Cottman Ave
Philadelphia PA 19149-1122
Phone: (215) 745-1444
Fax: (215) 745-1448
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG001074 | Pennsylvania |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OEG001074 | Pw |
Profile Details
| NPI number | 1467491274 |
|---|---|
| LBN Legal business name | Moore, Sandra M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Aug 27th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467491274 | NPPES |
| Pennsylvania | Other | 2193348000 | INDEPENDENCE BLUE CROSS |
| Pennsylvania | Other | 2193348000 | INDEPENDENCE BLUE CROSS |
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