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NPI Code Detail

MEDICARE: DAVID S ALTENDERFER OD LLC

MEDICARE: DAVID S ALTENDERFER OD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOEG001271PA

General Provider Information

NPI Number : 1013449230
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID S ALTENDERFER OD LLC
Provider Business Mailing Address
First Line : 518 WALLER WAY
Second Line :
City : JEFFERSONVILLE
State : PA
Zip : 19403-3543
Country : US
Telephone Number : 484-566-9242
Fax Number :
Provider Business Practice Location Address
First Line : 147 PALMER PARK MALL
Second Line :
City : EASTON
State : PA
Zip : 18045-2759
Country : US
Telephone Number : 610-258-4372
Fax Number : 610-258-5878
Authorized Official
Title or Position : OWNER
Name : DR. DAVID STEVEN ALTENDERFER
Credential : OD
Telephone Number : 484-566-9242
Provider Enumeration Date : 03/28/2017
Last Update Date : 03/28/2017

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Directions to “DAVID S ALTENDERFER OD LLC ” Practice Location

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