Joanne M Rodriguez, ABOC
Individual provider Active NPI Optician · Shamokin, PA
NPI 1245046358 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1245046358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 253830 (PA)
- Practice address
- 30 S Shamokin St
Shamokin, PA 17872-6028 - Phone
- (570) 648-8877
- NPI assigned
- Dec 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 253830 | PA | MD | Optician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 253830 | PA | Yes |
Addresses
Primary practice location
30 S Shamokin St
Shamokin, PA 17872-6028
Mailing address
30 S Shamokin St
Shamokin, PA 17872-6028
Phone (570) 648-8877
Other providers in Shamokin, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.