Provider Demographics
NPI:1407514631
Name:ADEM, AYLIN (OD)
Entity Type:Individual
Prefix:DR
First Name:AYLIN
Middle Name:
Last Name:ADEM
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 1:411 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6116
Mailing Address - Country:US
Mailing Address - Phone:646-270-5389
Mailing Address - Fax:
Practice Address - Street 1:411 BARNUM AVENUE CUTOFF STE 9
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-8001
Practice Address - Country:US
Practice Address - Phone:475-236-3013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-05
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003863152W00000X
CT3.003289152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist