Jeffrey Gonz, OPTICIAN
Individual provider Active NPI Optician · Hallstead, PA
NPI 1629101712 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629101712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- Practice address
- 19 Main St
Hallstead, PA 18822 - Phone
- (570) 879-2302
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Binghampton Optical Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Yes |
Addresses
Primary practice location
19 Main St
Hallstead, PA 18822
Mailing address
19 Main St
Hallstead, PA 18822
Phone (570) 879-2302
Other providers in Hallstead, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.