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NPI Code Detail

MEDICARE: DR. JEFFREY B BECKER OD

MEDICARE:  DR. JEFFREY B BECKER  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
1152W00000XOptometristOEG001067PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110732OTHERPAGEISINGER
296052OTHERPAVBA
32527358OTHERPAAETNA
4391844OTHERPANVA
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6BE131412OTHERPABLUE CROSS BLUE SHIELD
7818492OTHERPAFIRST PRIORITY

General Provider Information

NPI Number : 1568556918
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY B BECKER OD
Provider Business Mailing Address
First Line : 3373 LAKE ARIEL HWY STE C
Second Line :
City : HONESDALE
State : PA
Zip : 18431-1174
Country : US
Telephone Number : 570-253-6551
Fax Number : 570-253-6553
Provider Business Practice Location Address
First Line : 3373 LAKE ARIEL HWY STE C
Second Line :
City : HONESDALE
State : PA
Zip : 18431-1174
Country : US
Telephone Number : 570-253-6551
Fax Number : 570-253-6553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JEFFREY B BECKER OD” Practice Location

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