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General NPI Number Information
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NPI Number | 1215695994
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Entity Type | Organization
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Legal Business Name | YEALY EYE EAST YORK, LLC
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 2161 E MARKET ST
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City | YORK
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State | PA
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Zip | 17402-2848
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Country | US
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Telephone | 302-727-1384
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Fax |
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Provider Business Mailing Address
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Address Line | 244 N QUEEN ST
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City | LANCASTER
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State | PA
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Zip | 17603-3512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MICHAEL A KERNISKY
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Credential |
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Telephone | 717-201-3238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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