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NPI 1477539104

NPI 1477539104 : GREGORY L BITTNER OD : SOMERSET, PA

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General NPI Number Information
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    NPI Number           |    1477539104
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    Entity Type          |    Individual 
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    Provider Name        |    GREGORY L BITTNER OD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/15/2005
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    Last Update Date     |    07/18/2016
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Provider Practice Location Address
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    Address Line         |    268 W UNION ST 
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    City                 |    SOMERSET
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    State                |    PA
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    Zip                  |    15501-1539
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    Country              |    US
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    Telephone            |    814-445-6664
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    Fax                  |    814-443-1108
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Provider Business Mailing Address
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    Address Line         |    268 W UNION ST 
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    City                 |    SOMERSET
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    State                |    PA
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    Zip                  |    15501-1539
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    Country              |    US
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    Telephone            |    814-445-6664
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    Fax                  |    814-443-1108
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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       |    OEG000649
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    License Number State |    PA
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