Healthcare Provider Details

I. General information

NPI: 1356526966
Provider Name (Legal Business Name): DAVID L. STREISFELD, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 NORMAN DR
LEBANON PA
17042-7444
US

IV. Provider business mailing address

834 NORMAN DR
LEBANON PA
17042-7444
US

V. Phone/Fax

Practice location:
  • Phone: 717-272-6000
  • Fax: 717-272-6118
Mailing address:
  • Phone: 717-272-6000
  • Fax: 717-272-6118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD035567E
License Number StatePA

VIII. Authorized Official

Name: JACQUELYN FRAZIER
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 717-838-6462