NPIMap

Organization Active NPI

Sidney I & Jerry P Davidoff PTR

  • Optometrist
  • Broomall, PA
National Provider Identifier
1356313688
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000157 Issued in PA
Legal business name
SIDNEY I & JERRY P DAVIDOFF PTR
Practice address
2805 W Chester Pike
Broomall, PA 19008-1827
Phone
(610) 356-3933
Fax
(610) 356-3324
NPI assigned
Feb 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jerry Philip Davidoff, O.D.
Title
Partner
Phone
(610) 356-3933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG000157 PA Primary

Addresses

Primary practice location

2805 W Chester Pike
Broomall, PA 19008-1827

Mailing address

2805 W Chester Pike
PO Box 188
Broomall, PA 19008-1827
Phone (610) 356-3933

National Provider Directory

National Provider Directory

Locations

2805 W Chester Pike
Broomall, PA 19008
Phone (610) 356-3933

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1356313688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 W CHESTER PIKE",
            "address_2": "PO BOX 188",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190081827",
            "telephone_number": "610-356-3933",
            "fax_number": "610-356-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 W CHESTER PIKE",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190081827",
            "telephone_number": "610-356-3933",
            "fax_number": "610-356-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY I & JERRY P DAVIDOFF PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "DAVIDOFF",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "610-356-3933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.