Healthcare Provider Details

I. General information

NPI: 1265573232
Provider Name (Legal Business Name): SHELLEY ESKIN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 CAREY AVE
WILKES BARRE PA
18702-1430
US

IV. Provider business mailing address

602 CAREY AVE
WILKES BARRE PA
18702-1430
US

V. Phone/Fax

Practice location:
  • Phone: 570-826-1700
  • Fax: 570-826-3026
Mailing address:
  • Phone: 570-826-1700
  • Fax: 570-826-3026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOE006498P
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: