Mary Blair Long, O.D.

Individual provider Active NPI Optometrist · Dickson City, PA

NPI 1669604641 · NPPES record last updated Apr 24, 2013

Key facts

NPI
1669604641
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
OEG002240 (PA)
Practice address
900 Commerce Blvd
Vision Center #1884 Next to Walmart
Dickson City, PA 18519-1767
Phone
(570) 383-9358
Fax
(570) 383-1205
NPI assigned
Aug 10, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OEG002240PAMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002240 PA Yes

Addresses

Primary practice location

900 Commerce Blvd
Vision Center #1884 Next to Walmart
Dickson City, PA 18519-1767

Mailing address

900 Commerce Blvd
Vision Center #1884 Next to Walmart
Dickson City, PA 18519-1767
Phone (570) 383-9358

Other providers in Dickson City, PA

All providers in Dickson City, PA · Optometrist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.