1730292871 NPI number — DR. ANNE MARGARET MAYER O.D.

Table of content: DR. ANNE MARGARET MAYER O.D. (NPI 1730292871)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730292871 NPI number — DR. ANNE MARGARET MAYER O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAYER
Provider First Name:
ANNE
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730292871
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2236 CANTERBURY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MECHANICSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17055-5770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-761-2295
Provider Business Mailing Address Fax Number:
717-761-8123

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4900 CARLISLE PIKE
Provider Second Line Business Practice Location Address:
HAMPDEN OPTICAL
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-661-2295
Provider Business Practice Location Address Fax Number:
717-761-8123
Provider Enumeration Date:
08/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OEOO-7049P , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 396572 . This is a "CAPITAL BLUE CROSS ID#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 396572 . This is a "NVA PROVIDER ID#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: MA565249 . This is a "BLUE SHIELD ID#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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