Provider Demographics
NPI:1861995938
Name:SPECTIX HAVERFORD
Entity type:Organization
Organization Name:SPECTIX HAVERFORD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEYBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-564-6666
Mailing Address - Street 1:222 W RITTENHOUSE SQ
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5705
Mailing Address - Country:US
Mailing Address - Phone:215-564-6666
Mailing Address - Fax:215-564-6667
Practice Address - Street 1:222 W RITTENHOUSE SQ
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5705
Practice Address - Country:US
Practice Address - Phone:215-564-6666
Practice Address - Fax:215-564-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty