Healthcare Provider Details

I. General information

NPI: 1427115799
Provider Name (Legal Business Name): OCULOPLASTIC CONSULTANTS OF CENTRAL PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 UNION DEPOSIT RD #230
HARRISBURG PA
17111
US

IV. Provider business mailing address

4700 UNION DEPOSIT RD #230
HARRISBURG PA
17111
US

V. Phone/Fax

Practice location:
  • Phone: 717-541-9700
  • Fax: 717-541-9705
Mailing address:
  • Phone: 717-541-9700
  • Fax: 717-541-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN J SCHIETROMA
Title or Position: OWNER
Credential: MD
Phone: 717-541-9700