Healthcare Provider Details

I. General information

NPI: 1649239526
Provider Name (Legal Business Name): MARY DRUMMOND-ECK O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 BLUE VALLEY DR
BANGOR PA
18013-1526
US

IV. Provider business mailing address

401 MAIN ST
STOCKERTOWN PA
18083-7004
US

V. Phone/Fax

Practice location:
  • Phone: 610-599-6220
  • Fax: 610-599-6218
Mailing address:
  • Phone: 610-599-6220
  • Fax: 610-599-6218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOET009092
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: