Provider Demographics
NPI:1265529812
Name:MAJOR, ARCHIMA NYEMADY (OD, FAAO)
Entity type:Individual
Prefix:
First Name:ARCHIMA
Middle Name:NYEMADY
Last Name:MAJOR
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 TOWNSHIP LINE RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-5034
Mailing Address - Country:US
Mailing Address - Phone:610-446-3939
Mailing Address - Fax:610-446-3938
Practice Address - Street 1:1204 TOWNSHIP LINE RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-5034
Practice Address - Country:US
Practice Address - Phone:610-446-3939
Practice Address - Fax:610-446-3938
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014540380001Medicaid
PAU98189Medicare UPIN
PA095582Medicare PIN