| |
10 Kimberly Ln, Cranberry, PA 16319-3134 | |
(814) 676-6979 | |
(814) 676-6970 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 10 Kimberly Ln, Cranberry, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417124934 | NPI | - | NPPES |
001922253 0005 | Medicaid | PA | |
102649777 0001 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OEG000069 (Pennsylvania) | Primary |
Provider Name | Gregory E Dziubek |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1700812849 PECOS PAC ID: 9931298296 Enrollment ID: I20071210000280 |
Provider Name | Kathy J Marcoe |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1801902994 PECOS PAC ID: 7719888064 Enrollment ID: I20111108000801 |
Mailing Address | Practice Location Address |
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Po Box 94, Grove City, PA 16127-0094 Ph: (814) 676-6979 | 10 Kimberly Ln, Cranberry, PA 16319-3134 Ph: (814) 676-6979 |
Dr. Kathy J. Marcoe, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 10 Kimberly Ln, Cranberry, PA 16319 Phone: 814-676-6081 Fax: 814-676-6006 |