Provider Demographics
NPI:1912191248
Name:GURWOOD, IRVING (OD)
Entity Type:Individual
Prefix:DR
First Name:IRVING
Middle Name:
Last Name:GURWOOD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 HEATHER RD
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1109
Mailing Address - Country:US
Mailing Address - Phone:215-355-8751
Mailing Address - Fax:215-355-2729
Practice Address - Street 1:91 HEATHER RD
Practice Address - Street 2:
Practice Address - City:CHURCHVILLE
Practice Address - State:PA
Practice Address - Zip Code:18966-1109
Practice Address - Country:US
Practice Address - Phone:215-355-8751
Practice Address - Fax:215-355-2729
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist