MEDICARE: DR. HELEN J. CHANDOHA-KNOTT 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-000866	PA

General Provider Information

NPI Number	:	1750324596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELEN J. CHANDOHA-KNOTT O.D.

Provider Business Mailing Address
First Line	:	106 ASH LN
Second Line	:
City	:	COVINGTON TOWNSHIP
State	:	PA
Zip	:	18444-9110
Country	:	US
Telephone Number	:	570-842-3539
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 N BROAD ST
Second Line	:
City	:	WEST HAZLETON
State	:	PA
Zip	:	18202-1551
Country	:	US
Telephone Number	:	570-455-1100
Fax Number	:	570-455-1101

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	05/23/2023

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