Healthcare Provider Details
I. General information
NPI: 1912780131
Provider Name (Legal Business Name): HARVATINE EYECARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2023
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1831 LYCOMING CREEK RD
WILLIAMSPORT PA
17701-1523
US
IV. Provider business mailing address
1730 BRISTOL AVE APT 802
STATE COLLEGE PA
16801-3018
US
V. Phone/Fax
- Phone: 570-323-1111
- Fax:
- Phone: 231-580-1102
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHERINE
HARVATINE
Title or Position: PRESIDENT
Credential: OD
Phone: 231-580-1102