MEDICARE: GERALD G. SOLTIS O.D.

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	OEG001099	PA

General Provider Information

NPI Number	:	1518969047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD G. SOLTIS O.D.

Provider Business Mailing Address
First Line	:	214 W NEW CASTLE ST
Second Line	:
City	:	ZELIENOPLE
State	:	PA
Zip	:	16063-1154
Country	:	US
Telephone Number	:	724-452-6675
Fax Number	:	724-452-6607

Provider Business Practice Location Address
First Line	:	214 W NEW CASTLE ST
Second Line	:
City	:	ZELIENOPLE
State	:	PA
Zip	:	16063-1154
Country	:	US
Telephone Number	:	724-452-6675
Fax Number	:	724-452-6607

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/31/2008

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