MEDICARE: ERIKA E MABUS OD PC

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	OEG002826	PA

General Provider Information

NPI Number	:	1730661422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIKA E MABUS OD PC

Provider Business Mailing Address
First Line	:	2214 ROUTE 405 HWY
Second Line	:
City	:	MUNCY
State	:	PA
Zip	:	17756-6530
Country	:	US
Telephone Number	:	570-546-6129
Fax Number	:

Provider Business Practice Location Address
First Line	:	2214 ROUTE 405 HWY
Second Line	:
City	:	MUNCY
State	:	PA
Zip	:	17756-6530
Country	:	US
Telephone Number	:	570-546-6129
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF OPTOMETRY
Name	:	DR. ERIKA ELIZABETH MABUS CARPER
Credential	:	OD
Telephone Number	:	570-546-6129

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	06/26/2024

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