Provider Demographics
NPI:1386816999
Name:BRUCE J SEILER OD
Entity Type:Organization
Organization Name:BRUCE J SEILER OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEILER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-338-3849
Mailing Address - Street 1:7215 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-1010
Mailing Address - Country:US
Mailing Address - Phone:215-338-3849
Mailing Address - Fax:215-708-2136
Practice Address - Street 1:7215 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-1010
Practice Address - Country:US
Practice Address - Phone:215-338-3849
Practice Address - Fax:215-708-2136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000962332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0168850001Medicare NSC