Provider Demographics
NPI:1063834141
Name:MORRELL OPTICAL INC
Entity Type:Organization
Organization Name:MORRELL OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-632-6698
Mailing Address - Street 1:3810 MORRELL AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1915
Mailing Address - Country:US
Mailing Address - Phone:215-632-6698
Mailing Address - Fax:215-568-0661
Practice Address - Street 1:3810 MORRELL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1915
Practice Address - Country:US
Practice Address - Phone:215-632-6698
Practice Address - Fax:215-568-0661
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty