Dr. Alethea Wessner LLC

Organization Active NPI Optometrist · Pine Grove, PA

NPI 1881966265 · NPPES record last updated Feb 4, 2013

Key facts

NPI
1881966265
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
OEG000477 (PA)
Legal business name
DR. ALETHEA WESSNER LLC
Practice address
231 S Tulpehocken St
Pine Grove, PA 17963-1037
Phone
(570) 345-0188
Fax
(570) 345-0267
NPI assigned
Feb 1, 2012
Organization subpart
No

Authorized official

Name
Dr. Alethea Wessner, D.O.
Title
Optometrist/Owner
Phone
(570) 345-0188

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120611000408 PA Part B Supplier - Clinic/Group Practice 4981868544 Receives reassigned benefits from 1 practitioner
Practice locations: Pine Grove, PA
O20180306002209 PA DME Supplier - Physician - Optometrist 4981868544 Practice locations: Pine Grove, PA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X OEG000477 PA Yes

Addresses

Primary practice location

231 S Tulpehocken St
Pine Grove, PA 17963-1037

Mailing address

231 S Tulpehocken St
Pine Grove, PA 17963-1037
Phone (570) 345-0188

Other identifiers

IdentifierTypeStateIssuer
1881966265OtherPANPI

Other providers in Pine Grove, PA

All providers in Pine Grove, PA · Optometrist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.