Provider Demographics
NPI:1952355117
Name:KARLINER, MICHAEL A (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:KARLINER
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 1:508 ROCK GLEN DR
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2621
Mailing Address - Country:US
Mailing Address - Phone:610-304-4724
Mailing Address - Fax:
Practice Address - Street 1:7516 CITY LINE AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2102
Practice Address - Country:US
Practice Address - Phone:215-878-7181
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA6898T152W00000X
NJ4906152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAKA636585Medicare ID - Type Unspecified
NJKA710666Medicare ID - Type Unspecified
U06325Medicare UPIN