MEDICARE: DR. B. DEAN NARDIS O.D.

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	OEG000679	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	37415	OTHER	PA	AVESIS
2	49451	OTHER	PA	DAVIS VISION
3	24830	OTHER	PA	STARMOUNT
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	710862119	OTHER	PA	NVA
6	09389	OTHER	PA	SPECTERA
7	22802	OTHER	PA	BLUE SHIELD
8	42379	OTHER	PA	DAVIS VISION
9	919526	OTHER	PA	BLOCK VISION
10	37444	OTHER	PA	AVESIS

General Provider Information

NPI Number	:	1467563676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. B. DEAN NARDIS O.D.

Provider Business Mailing Address
First Line	:	344 HICKORY LN
Second Line	:
City	:	BELLEVILLE
State	:	PA
Zip	:	17004-8930
Country	:	US
Telephone Number	:	717-329-6588
Fax Number	:

Provider Business Practice Location Address
First Line	:	4461 E. MAIN ST.
Second Line	:
City	:	BELLEVILLE
State	:	PA
Zip	:	17004-9266
Country	:	US
Telephone Number	:	717-329-6588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/06/2009

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Directions to “ DR. B. DEAN NARDIS O.D.” Practice Location

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