Provider Demographics
NPI:1942565759
Name:KULICH, SARAH (OD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KULICH
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 1:310 SAW MILL LN
Mailing Address - Street 2:APT 12B
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1925
Mailing Address - Country:US
Mailing Address - Phone:724-421-5719
Mailing Address - Fax:
Practice Address - Street 1:1098 WASHINGTON CROSSING RD
Practice Address - Street 2:SUITE 5
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977-1343
Practice Address - Country:US
Practice Address - Phone:215-493-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-08
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002656152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist