Healthcare Provider Details

I. General information

NPI: 1558349530
Provider Name (Legal Business Name): SANDFORD C FRISCH MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/25/2013
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: MS. JODIE PAMELA FRISCH
Title or Position: ADMINISTRATOR
Credential:
Phone: 717-569-0600