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General NPI Number Information
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NPI Number | 1922252758
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Entity Type | Organization
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Legal Business Name | YOUR FAMILY EYE DOCTORS, INC.
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 20475 ROUTE 19
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-7529
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Country | US
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Telephone | 724-776-1079
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Fax | 724-742-1233
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Provider Business Mailing Address
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Address Line | 8775 NORWIN AVE
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City | N HUNTINGDON
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State | PA
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Zip | 15642-2718
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Country | US
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Telephone | 724-864-7777
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Fax | 724-864-7779
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUSTINE A CAKANAC
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Credential | O.D.
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Telephone | 724-864-7777
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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 | OEG000583
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License Number State | PA
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