Healthcare Provider Details

I. General information

NPI: 1710049143
Provider Name (Legal Business Name): PEASE-SIEBER EYE ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 TECPORT DR SUITE 170
HARRISBURG PA
17111-1465
US

IV. Provider business mailing address

3950 TECPORT DR SUITE 170
HARRISBURG PA
17111-1465
US

V. Phone/Fax

Practice location:
  • Phone: 717-564-5211
  • Fax: 717-564-5280
Mailing address:
  • Phone: 717-564-5211
  • Fax: 717-564-5280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOEG001334
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000196
License Number StatePA

VIII. Authorized Official

Name: DR. AUDRA WARREN SIEBER
Title or Position: PRESIDENT
Credential: O.D.
Phone: 717-564-5211