MEDICARE: SANTASANIA EYECARE

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	OEG000257	PA

General Provider Information

NPI Number	:	1386728525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTASANIA EYECARE

Provider Business Mailing Address
First Line	:	HC 89
Second Line	:	ROUTE 940, P.O. BOX 127
City	:	POCONO SUMMIT
State	:	PA
Zip	:	18346-0127
Country	:	US
Telephone Number	:	570-839-5746
Fax Number	:	579-839-5748

Provider Business Practice Location Address
First Line	:	HC 89
Second Line	:
City	:	POCONO SUMMIT
State	:	PA
Zip	:	18346-9801
Country	:	US
Telephone Number	:	570-839-5746
Fax Number	:	579-839-5748

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD JOSEPH SANTASANIA
Credential	:	O.D.
Telephone Number	:	570-839-5746

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	08/22/2020

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Directions to “SANTASANIA EYECARE ” Practice Location

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