Provider Demographics
NPI:1356354583
Name:POLECTION, MARCHA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:MARCHA
Middle Name:MARIE
Last Name:POLECTION
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MARCHA
Other - Middle Name:MARIE
Other - Last Name:POLECTION-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1124 WILSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19001
Mailing Address - Country:US
Mailing Address - Phone:215-224-2347
Mailing Address - Fax:215-224-2309
Practice Address - Street 1:521 WEST OLNEY AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120
Practice Address - Country:US
Practice Address - Phone:215-224-2347
Practice Address - Fax:215-224-2309
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000848152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101339466 0001Medicaid
PA078333YBGTMedicare PIN
PAU99604Medicare UPIN