Alpha Optical Bethlehem, LLC
Organization Active NPI Optometrist · Easton, PA
NPI 1306484589 · NPPES record last updated Feb 3, 2020
Key facts
- NPI
- 1306484589
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ALPHA OPTICAL BETHLEHEM, LLC
- Practice address
- 4753 Freemansburg Ave
Easton, PA 18045-5529 - Phone
- (610) 866-1000
- NPI assigned
- Dec 18, 2019
- Organization subpart
- No
Authorized official
- Name
- Gretchen Brewer, OD
- Title
- President
- Phone
- (267) 481-2360
Practitioners 4
-
Kevin C Bistline, O.D.
-
Gretchen Brewer, OD
-
Thomas M Gulibon Jr., O.D.
-
Gary Jon Kokosky, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200210000035 | PA | Part B Supplier - Clinic/Group Practice | 2961838032 |
Receives reassigned benefits from 4 practitioners Practice locations: Easton, PA |
National Provider Directory
Locations
4753 Freemansburg Ave
Palmer Township, PA 18045
Phone (610) 866-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
4753 Freemansburg Ave
Easton, PA 18045-5529
Mailing address
103 Dickens CT
North Wales, PA 19454-1622
Phone (267) 481-2360
Other providers in Easton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.