Healthcare Provider Details

I. General information

NPI: 1316231764
Provider Name (Legal Business Name): ARIANA JAVANEH INGSTAD O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2011
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 HIGH POINT BLVD STE 800
BETHLEHEM PA
18017-7816
US

IV. Provider business mailing address

3535 HIGH POINT BLVD STE 800
BETHLEHEM PA
18017-7816
US

V. Phone/Fax

Practice location:
  • Phone: 610-867-9900
  • Fax: 610-867-0730
Mailing address:
  • Phone: 610-867-9900
  • Fax: 610-867-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG003246
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: