MEDICARE: KELSEY HARNISH OD

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	152W00000X	Optometrist	OEG003826	PA

General Provider Information

NPI Number	:	1326711334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY HARNISH OD

Provider Business Mailing Address
First Line	:	218 W MAIN ST
Second Line	:
City	:	NEWMANSTOWN
State	:	PA
Zip	:	17073-9113
Country	:	US
Telephone Number	:	610-763-5843
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 W LINCOLN AVE
Second Line	:
City	:	MYERSTOWN
State	:	PA
Zip	:	17067-2332
Country	:	US
Telephone Number	:	717-866-2030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	07/26/2021

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