Healthcare Provider Details

I. General information

NPI: 1477512473
Provider Name (Legal Business Name): J D PEARAH MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 PENN AVENUE
SINKING SPRING PA
19608-1174
US

IV. Provider business mailing address

3855 PENN AVENUE
SINKING SPRING PA
19608-1174
US

V. Phone/Fax

Practice location:
  • Phone: 610-678-4716
  • Fax: 610-678-7007
Mailing address:
  • Phone: 610-678-4552
  • Fax: 610-678-7007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD057801L
License Number StatePA

VIII. Authorized Official

Name: DR. PETER C CAMPANELLA
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 610-678-4552