MEDICARE: GAIL S PELOSI 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	152WC0802X	Corneal and Contact Management Optometrist	OEG 001081	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3474959	OTHER	PA	AETNA OPTOMETRIST
2	PE 660212	OTHER	PA	HIGHMARK/BLU SHIELD
3	20349	OTHER	PA	SPECTERA OPTOMETRIST
4	PA 1081	OTHER	PA	EYEMED OPTOMETRIST
5	44784	OTHER	PA	DAVIS VISION
6	1252700	OTHER	PA	MAID
7	397501	OTHER	PA	NAT'L VISION ADMINISTRATO
8	6102530750	OTHER	PA	VSP

General Provider Information

NPI Number	:	1649229527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL S PELOSI O.D.

Provider Business Mailing Address
First Line	:	2925 WILLIAM PENN HWY
Second Line	:	SUITE 300
City	:	EASTON
State	:	PA
Zip	:	18045-5283
Country	:	US
Telephone Number	:	610-253-0750
Fax Number	:	610-253-2121

Provider Business Practice Location Address
First Line	:	2925 WILLIAM PENN HWY
Second Line	:	SUITE 300
City	:	EASTON
State	:	PA
Zip	:	18045-5283
Country	:	US
Telephone Number	:	610-253-0750
Fax Number	:	610-253-2121

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	11/09/2007

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Directions to “ GAIL S PELOSI O.D.” Practice Location

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