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General NPI Number Information
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NPI Number | 1649413253
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Entity Type | Organization
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Legal Business Name | FREELAND EYE ASSOCIATES
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 509 CENTRE ST
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City | FREELAND
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State | PA
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Zip | 18224-1901
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Country | US
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Telephone | 570-636-0355
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Fax | 570-636-3285
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Provider Business Mailing Address
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Address Line | 509 CENTRE ST
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City | FREELAND
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State | PA
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Zip | 18224-1901
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Country | US
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Telephone | 570-636-0355
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Fax | 570-636-3285
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Authorized Official
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Title or Position | SOLE PROP
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Name | DR. JOHN T ANZELMI
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Credential | O.D.
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Telephone | 570-636-0355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OEG000326
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License Number State | PA
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