Provider Demographics
NPI:1821051723
Name:GURWOOD, DENISE LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LYNN
Last Name:GURWOOD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DENISE
Other - Middle Name:LYNN
Other - Last Name:WHARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:16 N FRANKLIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3536
Mailing Address - Country:US
Mailing Address - Phone:215-348-5551
Mailing Address - Fax:215-348-7151
Practice Address - Street 1:71 E ASHLAND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4631
Practice Address - Country:US
Practice Address - Phone:215-348-5551
Practice Address - Fax:215-348-7151
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001564152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5378430001Medicare NSC
PAGU555281Medicare PIN
PAU27772Medicare UPIN