Provider Demographics
NPI:1679762942
Name:DAO, AMY K (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:K
Last Name:DAO
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 1:311 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-2208
Mailing Address - Country:US
Mailing Address - Phone:215-888-9260
Mailing Address - Fax:
Practice Address - Street 1:1200 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2701
Practice Address - Country:US
Practice Address - Phone:610-605-3192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT007231152W00000X
NJ27OA00612400152W00000X
PAOEG002047152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB6363Medicare PIN
NYRB6362Medicare PIN
NYRB6364Medicare PIN
NYRB6365Medicare PIN