Andrea Joan Haddock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG001805 Issued in PA

Practice address

2150 Wilkes Barre Township Blvd
Wilkes Barre, PA 18702

Phone

(570) 882-2568

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Andrea Joan Yager Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609897008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 SCARBORO ST",
            "city": "EXETER",
            "state": "PA",
            "postal_code": "186432534",
            "telephone_number": "570-840-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 WILKES BARRE TOWNSHIP BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-882-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "ANDREA",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "YAGER",
            "middle_name": "JOAN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• H2 Health and Rehabilitation Services, LLC
• Anny Ha
• Julianna Rae Haas, PA-C
• Rebecca Leah Haberle, CRNP
• Lemuel E Hackshaw, MD
• Matthew Hadginske, PHARMD
• Brenda Hage, CRNP
• Muhammad Usman Haider, MD
• Lori Ann Haines, RN
• Ryan Haith, LPC

• Optometrist in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.