MEDICARE: JD PEARAH MD LTD

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
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1093827164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JD PEARAH MD LTD

Provider Business Mailing Address
First Line	:	3855 PENN AVENUE
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-1174
Country	:	US
Telephone Number	:	610-678-4716
Fax Number	:	610-678-7007

Provider Business Practice Location Address
First Line	:	3855 PENN AVENUE
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-1174
Country	:	US
Telephone Number	:	610-678-4716
Fax Number	:	610-678-7007

Authorized Official
Title or Position	:	PRESIDENT-OWNER
Name	:	PETER C CAMPANELLA
Credential	:	MD
Telephone Number	:	610-678-4552

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/22/2008

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