Basic Information
| Provider Information | |||||||||
| NPI: | 1831161744 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSTON | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 WOODMINT DR | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193802102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8135978147 | ||||||||
| FaxNumber: | 6106926007 | ||||||||
| Practice Location | |||||||||
| Address1: | 923 PAOLI PIKE | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193804527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106928300 | ||||||||
| FaxNumber: | 6106926007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2006 | ||||||||
| LastUpdateDate: | 01/07/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC 3715 | FL | N | Eye and Vision Services Providers | Optometrist | 152W00000X | OEG001893 | PA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.