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45 East Main St, Suite 201, Newark, DE 19711-4600 | |
(302) 224-3000 | |
(302) 224-1524 |
Full Name | |
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Type | Facility |
Speciality | Technician/technologist - Contact Lens Fitter |
Location | 45 East Main St, Newark, Delaware |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225159585 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | DE I30001215 (Delaware) | Primary |
156FC0801X | Technician/technologist - Contact Lens Fitter | DE I30001215 (Delaware) | Primary |
Provider Name | Yvonne S Kneisley |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1780613083 PECOS PAC ID: 4486748993 Enrollment ID: I20070914000225 |
Mailing Address | Practice Location Address |
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45 East Main St, Suite 201, Newark, DE 19711-4600 Ph: (302) 224-3000 | 45 East Main St, Suite 201, Newark, DE 19711-4600 Ph: (302) 224-3000 |