Provider Demographics
NPI:1801458849
Name:SUI, ALICE (OD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:SUI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MIDDLETOWN BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1863
Mailing Address - Country:US
Mailing Address - Phone:215-757-6200
Mailing Address - Fax:215-750-7875
Practice Address - Street 1:360 MIDDLETOWN BLVD STE 402
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1863
Practice Address - Country:US
Practice Address - Phone:215-757-6200
Practice Address - Fax:215-750-7875
Is Sole Proprietor?:No
Enumeration Date:2019-06-30
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003694152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty