RADOSLAV IVANOV (NPI# 1093120701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093120701 |
| Entity Type | Individual |
| Full Name | RADOSLAV IVANOV |
| Credential | OD |
| Practice Address |
401 N 17th St Suite 103 Allentown PA 18104-5034 |
| Practice Telephone | 6109693070 |
| Practice Fax Number | 6109693073 |
| Mailing Telephone | 6109693070 |
| Mailing Fax Number | 6109693073 |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2016-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OEG002925 | PA | Eye and Vision Services Providers |
| Street Address |
401 N 17TH ST SUITE 103 |
| City | ALLENTOWN |
| State | PA |
| Zip Code | 18104-5034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445827 | Walters Pharmacy Inc | Pharmacy | 401 N 17th St, Suite 102, Allentown, PA 18104-5034 | 2005-05-27 |
| 1306385018 | Rebecca Aul | Nurse Practitioner | 401 N 17th St, Suite 211, Allentown, PA 18104-5034 | 2017-02-14 |
| 1922477678 | Lehigh Valley Physician Group | Otolaryngology | 401 N 17th St, Ste 210, Allentown, PA 18104-5034 | 2015-09-23 |
| 1487067427 | Alexandra Lynn Mercurio-woch | Optometrist | 401 N 17th St, Suite 103, Allentown, PA 18104-5034 | 2014-06-07 |
| 1750727434 | Tasha Reck | Audiologist | 401 N 17th St, Suite 210, Allentown, PA 18104-5034 | 2013-05-21 |
| 1306109459 | Dalya Adel El Tawil | Pediatrics | 401 N 17th St, Suite 203, Allentown, PA 18104-5034 | 2012-06-22 |
| 1215266945 | Julie N Rohe | Physician Assistant | 401 N 17th St, Ste 307, Allentown, PA 18104-5034 | 2009-12-08 |
| 1265676852 | Lehigh Valley Physician Group | Internal Medicine | 401 N 17th St, Suite 201, Allentown, PA 18104-5034 | 2009-04-27 |
| 1467696054 | Lehigh Valley Physician Group | Internal Medicine | 401 N 17th St, Suite 202, Allentown, PA 18104-5034 | 2009-04-27 |
| 1801046354 | Christopher M Wolfe | Physician Assistant | 401 N 17th St, Suite 304, Allentown, PA 18104-5034 | 2008-09-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174134191 | The Calm Space LLC | Social Worker | 2047 Pa-309, Allentown, PA 18104 | 2020-08-13 |
| 1790333458 | Loanna T Nguyen | Nurse Practitioner | 2895 Halmilton Blvd, Suite 202, Allentown, PA 18104 | 2019-08-27 |
| 1093360513 | Meghan Paul | Pharmacist | 1727 W Liberty Street, Unit 2, Allentown, PA 18104 | 2019-08-02 |
| 1750948154 | Patricia Terreros | Counselor | 3057 College Heights Blvd Suite Ll, Allentown, PA 18104 | 2019-05-22 |
| 1023593084 | Hearvana | Clinic/Center | 2200 Wets Hamilton Street Suite 311, Allentown, PA 18104 | 2018-09-26 |
| 1700397098 | Amanda L Sellers | Psychologist | 121 N Cedar Crest Blvd Ste A, Allentown, PA 18104 | 2017-10-13 |
| 1689104457 | Craig Ryan Miller | Physical Therapist | 1651 N Cedar Crest Blvd Ste 100, Allentown, PA 18104 | 2017-06-14 |
| 1780128207 | Brandi Nicole Burns | Pediatrics | 1517 Pond Road, Allentown, PA 18104 | 2016-12-19 |
| 1750824264 | William Edward Thawley | Pharmacist | 322 N 7th St., Allentown, PA 18104 | 2016-12-01 |
| 1609222371 | Extremity Mri Inc | Radiologic Technologist | 3131 College Heights Blvd Ste 400, Allentown, PA 18104 | 2016-05-11 |
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| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689189003 | Manuel Santos | Optometrist | 1918 W Tilghman St, Allentown, PA 18104-4345 | 2017-12-07 |
| 1700305026 | Emily Chu Od PC | Optometrist | 3131 College Heights Blvd Ste 300, Allentown, PA 18104-4858 | 2017-09-18 |
| 1386096121 | Valley Primary Eye Care Specialists LLC | Optometrist | 4499 Driftwood Ln, Allentown, PA 18103-9233 | 2016-07-05 |
| 1851507511 | William Semmel Od PC | Optometrist | 3323 Hamilton Blvd, Allentown, PA 18103 | 2007-05-16 |
| 1124142740 | Binae Karpo | Optometrist | 2821 W Tilghman St, Allentown, PA 18104-4264 | 2007-03-19 |
| 1962566273 | Suzanne Marie Hauck | Optometrist | 524 N 19th St, Allentown, PA 18104-5045 | 2006-12-20 |
| 1023170669 | Marc M Berson | Optometrist | 2804 Walbert Ave, Allentown, PA 18104-2400 | 2006-12-13 |
| 1891856225 | Veena Adusumilli | Optometrist | 401 N 17th St Ste 103, Allentown, PA 18104-5049 | 2006-12-12 |
| 1609947001 | Pamela Sue Kimmel | Optometrist | 1091 Mill Creek Rd, Allentown, PA 18106 | 2006-11-10 |
| 1467547570 | R. Douglas Quay | Optometrist | 2030 W Tilghman St Ste 101, Allentown, PA 18104-4354 | 2006-10-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.