Provider Demographics
NPI:1558470260
Name:TAYLOR, DYTARSHA MAEIR (OD)
Entity type:Individual
Prefix:DR
First Name:DYTARSHA
Middle Name:MAEIR
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1667 ROYAL BERKSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1598
Mailing Address - Country:US
Mailing Address - Phone:610-444-9681
Mailing Address - Fax:610-444-9713
Practice Address - Street 1:516 SCHOOL HOUSE RD
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1742
Practice Address - Country:US
Practice Address - Phone:610-444-9681
Practice Address - Fax:610-444-9713
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG001048152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist