Provider / Organization | NPI | Date Certified |
---|---|---|
ANTONINA KORNEEVA | 1275182842 | 2019-09-06 |
Antonina Korneeva [F] graduated in 2019 from Pennsylvania College Of Optometry and primarily specializes in Optometry.
Antonina Korneeva is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1275182842. Registration indicates Antonina Korneeva is a provider of access to ophthalmic care services with a specialization in Eye & Vision Services Providers, Optometrist (Eye and Vision Services Providers, Optometrist) (Optometrist, ) (Vision/Audiology, ) (Optometrist, Eye and Vision Services Providers)
PECOS ID | 8426479916 |
Registration | PART-B:Y DME:Y HHA:Y PMD:N |
Entity Type | Individual |
Provider Name | Dr. Antonina Korneeva OD |
Practice Office Address | 1919 CHESTNUT ST LBBY 105 PHILADELPHIA, PA US |
Practice Office Telephone | 2155638440 |
Practice Office Fax | 2155674993 |
Mailing Address | 1919 CHESTNUT ST LBBY 105 PHILADELPHIA, PA 191033456 US |
Business Telephone | 2155638440 |
Business Fax | 2155674993 |
Code | Practice | License No State |
---|---|---|
152W00000X PRIMARY | Access to Ophthalmic Care Eye & Vision Services Providers Optometrist Eye and Vision Services Providers Optometrist Optometrist Vision/Audiology Optometrist Eye and Vision Services Providers | OEG003762
PA |