Provider Demographics
NPI:1861403743
Name:SWIATOCHA-DELATTE, JANET (OPTOMETRIST)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:
Last Name:SWIATOCHA-DELATTE
Suffix:
Gender:F
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 COUNTY ROAD 513
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08825-3734
Mailing Address - Country:US
Mailing Address - Phone:908-996-3444
Mailing Address - Fax:215-276-1329
Practice Address - Street 1:1200 W GODFREY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3323
Practice Address - Country:US
Practice Address - Phone:215-276-6000
Practice Address - Fax:215-276-1329
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1547363OtherBLUE SHIELD
PA2230875000OtherKEYSTONE EAST
PA2248OtherAETNA HMO
PA1547363OtherBLUE SHIELD
PAU19318Medicare UPIN