Provider Demographics
NPI:1528469384
Name:SWINDELL, OLAYEMI VICTORIA (OD)
Entity type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:VICTORIA
Last Name:SWINDELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 MAPLEWOOD MEWS
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1946
Mailing Address - Country:US
Mailing Address - Phone:301-613-9336
Mailing Address - Fax:
Practice Address - Street 1:100 EVERGREEN DR
Practice Address - Street 2:SUITE 117
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1056
Practice Address - Country:US
Practice Address - Phone:610-558-9803
Practice Address - Fax:610-558-7612
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG0003003152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist