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General NPI Number Information
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NPI Number | 1336421965
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Entity Type | Organization
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Legal Business Name | NITTANY EYE ASSOCIATES
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 175 HOSPITAL DRIVE
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City | TYRONE
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State | PA
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Zip | 16686
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Country | US
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Telephone | 814-684-5306
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Fax | 814-684-2359
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Provider Business Mailing Address
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Address Line | 175 HOSPITAL DR
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City | TYRONE
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State | PA
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Zip | 16686
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Country | US
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Telephone | 814-684-5306
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Fax | 814-684-2359
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MICHAEL J CYMBOR
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Credential | O.D.
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Telephone | 814-684-5306
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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 | OEG000066
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License Number State | PA
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