Provider Demographics
NPI:1164486387
Name:SAPOSSNEK, ROBIN (OD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SAPOSSNEK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 HENRIETTA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-8523
Mailing Address - Country:US
Mailing Address - Phone:215-663-5933
Mailing Address - Fax:215-663-5933
Practice Address - Street 1:930 HENRIETTA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-8523
Practice Address - Country:US
Practice Address - Phone:215-663-5933
Practice Address - Fax:215-663-5933
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000516152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0666840001Medicare NSC