Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OE007320 | PA |
NPI | 1013325687 |
---|---|
Provider Name | Sylvia Schueller-Gruzin |
First Address | Bensalem, PA 19020-1103 |
Second Address | Bensalem, PA 19020-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2014 |
Last Update Date | 28/07/2014 |