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General NPI Number Information
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NPI Number | 1316193139
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Entity Type | Individual
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Provider Name | BROOKE MARIE CATANESE-SHEDLOCK O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 690 SHAFFER RD
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City | DUBOIS
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State | PA
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Zip | 15801-0000
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Country | US
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Telephone | 814-375-9280
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Fax |
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Provider Business Mailing Address
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Address Line | 612 CLARA ST SUITE 1
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City | HOUTZDALE
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State | PA
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Zip | 16651-1115
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Country | US
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Telephone | 814-378-7700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OEG002053
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License Number State | PA
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