Provider Demographics
NPI:1588603310
Name:PEARLMAN-STORCH, FRANCINE (OD)
Entity Type:Individual
Prefix:
First Name:FRANCINE
Middle Name:
Last Name:PEARLMAN-STORCH
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 1:2000 SPROUL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3509
Mailing Address - Country:US
Mailing Address - Phone:610-353-3916
Mailing Address - Fax:
Practice Address - Street 1:2000 SPROUL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3509
Practice Address - Country:US
Practice Address - Phone:610-353-3916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0033115000OtherKHPE/ BLUE SHIELD/ IBX
4490905OtherAETNA MANAGED CARE
55099OtherAETNA HMO
55099OtherAETNA HMO
T29444Medicare UPIN