MEDICARE: SKELTON EYE CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG003285	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285152025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKELTON EYE CARE PC

Provider Business Mailing Address
First Line	:	11820 HUNTERS RIDGE BLVD APT 3
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-6280
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9239 ROUTE 6
Second Line	:
City	:	UNION CITY
State	:	PA
Zip	:	16438-9727
Country	:	US
Telephone Number	:	814-438-2020
Fax Number	:	814-438-7976

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RACHELE MARGARET SIEGEL
Credential	:	OD
Telephone Number	:	814-657-8074

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	08/31/2017

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Directions to “SKELTON EYE CARE PC ” Practice Location

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