MEDICARE: LAURIE ANNE MCELRATH 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	OE-006600-T	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	:	1578591681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE ANNE MCELRATH O.D.

Provider Business Mailing Address
First Line	:	144 E NESHANNOCK AVE
Second Line	:
City	:	NEW WILMINGTON
State	:	PA
Zip	:	16142-1144
Country	:	US
Telephone Number	:	724-656-1117
Fax Number	:	724-656-1566

Provider Business Practice Location Address
First Line	:	144 E NESHANNOCK AVE
Second Line	:
City	:	NEW WILMINGTON
State	:	PA
Zip	:	16142-1144
Country	:	US
Telephone Number	:	724-656-1117
Fax Number	:	724-656-1566

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/25/2016

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