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NPI Code Detail

MEDICARE: BARBARA ANN GORDEUK OD LLC

MEDICARE: BARBARA ANN GORDEUK 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
1152W00000XOptometrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA6881OTHERPAEYEMED
236092OTHERPADAVIS VISION-WALMART
353028OTHERPADAVIS VISION-KEYSTONE
40192730000OTHERPAINDEPENDENCE BLUE CROSS
557599OTHERPAAETNA-US HEALTHCARE
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063523108
Entity Type Code : Organization
Provider Name (Legal Business Name) : BARBARA ANN GORDEUK OD LLC
Provider Business Mailing Address
First Line : 4899 DURHAM RD
Second Line :
City : PIPERSVILLE
State : PA
Zip : 18947-1151
Country : US
Telephone Number : 215-766-3997
Fax Number :
Provider Business Practice Location Address
First Line : 495 S OXFORD VALLEY RD
Second Line :
City : FAIRLESS HILLS
State : PA
Zip : 19030-4202
Country : US
Telephone Number : 215-949-6611
Fax Number : 215-949-6613
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. BARBARA ANN GORDEUK
Credential : O.D.
Telephone Number : 215-968-0203
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/30/2013

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Directions to “BARBARA ANN GORDEUK OD LLC ” Practice Location

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