Healthcare Provider Details

I. General information

NPI: 1407844616
Provider Name (Legal Business Name): SANDFORD CHARLES FRISCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 11/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 OREGON PIKE SUITE 102
LANCASTER PA
17601-4606
US

IV. Provider business mailing address

2207 OREGON PIKE SUITE 102
LANCASTER PA
17601-4606
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-0600
  • Fax: 717-569-4562
Mailing address:
  • Phone: 717-569-0600
  • Fax: 717-569-4562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number6000006421
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD042342E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: