Provider Demographics
NPI:1780780361
Name:SEILER, BRUCE J (OD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:J
Last Name:SEILER
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 1:7215 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-1010
Mailing Address - Country:US
Mailing Address - Phone:215-338-3849
Mailing Address - Fax:215-708-2136
Practice Address - Street 1:7215 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19135-1010
Practice Address - Country:US
Practice Address - Phone:215-338-3849
Practice Address - Fax:215-708-2136
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000962152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT30088Medicare UPIN
PA0168850001Medicare NSC
PA195526Medicare ID - Type Unspecified