Provider Demographics
NPI:1013066802
Name:CUTLER-FRANKEL, SHELLEY ILENE (OD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:ILENE
Last Name:CUTLER-FRANKEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SHELLEY
Other - Middle Name:ILENE
Other - Last Name:CUTLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:100 WEST AVE # 506S
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2625
Mailing Address - Country:US
Mailing Address - Phone:215-887-2035
Mailing Address - Fax:215-887-2035
Practice Address - Street 1:521 W BUTLER AVE
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2218
Practice Address - Country:US
Practice Address - Phone:267-875-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000949152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UO6323Medicare UPIN
484542Medicare ID - Type Unspecified