Provider Demographics
NPI:1689669020
Name:SEPAHI, ASAL H (OD)
Entity Type:Individual
Prefix:
First Name:ASAL
Middle Name:H
Last Name:SEPAHI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:830 OLD LANCASTER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3118
Mailing Address - Country:US
Mailing Address - Phone:610-527-0990
Mailing Address - Fax:610-527-7921
Practice Address - Street 1:830 OLD LANCASTER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3118
Practice Address - Country:US
Practice Address - Phone:610-527-0990
Practice Address - Fax:610-527-7921
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOE007974P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U64758Medicare UPIN
PA893733E45Medicare PIN