IndividualActive
Jamie Ellsworth-Neiman, OPTOMETRIST
NPI 1477565224 · Pediatric Optometrist · Philadelphia, PA
Provider details
- NPI number
- 1477565224
- Entity type
- Individual
- Primary specialty
- Pediatric OptometristEye and Vision Services Providers
- Credential
- OPTOMETRIST
- Sex
- Male
- Sole proprietor
- No
- License
- OEG000343 (PA)
Practice location
1200 W Godfrey Ave
Philadelphia, PA 19141-3323
Phone: (215) 276-6000
Fax: (215) 276-1329
Mailing address
50 Fieldstone Rd
Levittown, PA 19056-1917
Registry dates
- Enumerated
- 2006-08-12
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.