MEDICARE: THERESE C. DESCHENES, 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	OE006871-T	PA

General Provider Information

NPI Number	:	1922289305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERESE C. DESCHENES, OD; PC

Provider Business Mailing Address
First Line	:	2900 W GERMANTOWN PIKE
Second Line	:
City	:	TROOPER
State	:	PA
Zip	:	19403-1037
Country	:	US
Telephone Number	:	610-630-6633
Fax Number	:	610-630-8539

Provider Business Practice Location Address
First Line	:	2900 W GERMANTOWN PIKE
Second Line	:
City	:	TROOPER
State	:	PA
Zip	:	19403-1037
Country	:	US
Telephone Number	:	610-630-6633
Fax Number	:	610-630-8539

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THERESE CECELIA DESCHENES
Credential	:	OD
Telephone Number	:	610-630-6633

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	11/03/2008

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