Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG000440 | PA |
NPI | 1003881780 |
---|---|
Provider Name | Ines M Casado Strine |
First Address | Media, PA 19063-2615 |
Second Address | Media, PA 19063-2615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 31/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103247416-0001 | (05) | PA |
P00199174 | RAILROAD MEDICARE (01) | PA |
U72294 | (02) | PA |