Provider Demographics
NPI:1992869259
Name:CHMIELEWSKI, CHRISTINE M (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:CHMIELEWSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:CHMIELEWSKI
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4537 OLD OAK RD
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-8809
Mailing Address - Country:US
Mailing Address - Phone:215-816-2765
Mailing Address - Fax:
Practice Address - Street 1:4537 OLD OAK RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-8809
Practice Address - Country:US
Practice Address - Phone:215-816-2765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001019152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1417221763OtherNPI GROUP
PA1417221763OtherNPI GROUP