Amir Akhavan Azari, M.D.

Individual provider Active NPI Corneal and Contact Management Optometrist · Philadelphia, PA

NPI 1801068382 · NPPES record last updated Jan 30, 2014

Key facts

NPI
1801068382
Entity type
Individual (NPI type 1)
Primary specialty
Corneal and Contact Management Optometrist 152WC0802X
License
MD45090 (PA)
Practice address
840 Walnut St
Suit 920
Philadelphia, PA 19107-5109
Phone
(215) 928-3180
NPI assigned
Mar 25, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD45090PAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Eyecare, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X MD45090 PA Yes

Addresses

Primary practice location

840 Walnut St
Suit 920
Philadelphia, PA 19107-5109

Mailing address

840 Walnut St
Suite 920
Philadelphia, PA 19107-5109
Phone (215) 928-3180

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Corneal and Contact Management Optometrist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.