MEDICARE: DR. ELAINE MARIE GUZEK 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	OEG001138	PA

General Provider Information

NPI Number	:	1891956504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE MARIE GUZEK O.D.

Provider Business Mailing Address
First Line	:	921 VIEWMONT DR
Second Line	:
City	:	DICKSON CITY
State	:	PA
Zip	:	18519-1663
Country	:	US
Telephone Number	:	570-558-7221
Fax Number	:	570-558-7229

Provider Business Practice Location Address
First Line	:	921 VIEWMONT DR
Second Line	:
City	:	DICKSON CITY
State	:	PA
Zip	:	18519-1663
Country	:	US
Telephone Number	:	570-558-7221
Fax Number	:	570-558-7229

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

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	06/24/2008

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