Provider Demographics
NPI:1891990842
Name:WELDON LTD
Entity Type:Organization
Organization Name:WELDON LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WELDON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-742-1400
Mailing Address - Street 1:1936 COTTMAN AVENUE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3800
Mailing Address - Country:US
Mailing Address - Phone:215-742-1400
Mailing Address - Fax:215-742-0154
Practice Address - Street 1:1936 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19111-3800
Practice Address - Country:US
Practice Address - Phone:215-742-1400
Practice Address - Fax:215-742-0154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE008528152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA063487Medicare PIN
PA5506380001Medicare NSC
PAU92072Medicare UPIN