MEDICARE: DR. RICHARD FRANCIS TALAMO 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	OET009054	PA

General Provider Information

NPI Number	:	1518952530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD FRANCIS TALAMO O.D.

Provider Business Mailing Address
First Line	:	107 9TH AVE
Second Line	:
City	:	SHAMOKIN DAM
State	:	PA
Zip	:	17876-9210
Country	:	US
Telephone Number	:	570-743-0427
Fax Number	:	570-743-1147

Provider Business Practice Location Address
First Line	:	109 MONROE ST
Second Line	:	SUITE 40
City	:	SELINSGROVE
State	:	PA
Zip	:	17870-7672
Country	:	US
Telephone Number	:	570-743-0427
Fax Number	:	570-743-1147

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	12/16/2015

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