Provider Demographics
NPI:1497802136
Name:PANDIT, GINA (OD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:PANDIT
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 1:180 LEVITTOWN PKWY
Mailing Address - Street 2:C/O WALMART VISION CENTER
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-2456
Mailing Address - Country:US
Mailing Address - Phone:215-949-6611
Mailing Address - Fax:
Practice Address - Street 1:180 LEVITTOWN PKWY
Practice Address - Street 2:C/O WALMART VISION CENTER
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-2456
Practice Address - Country:US
Practice Address - Phone:215-949-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002566152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist