Provider Demographics
NPI:1003809401
Name:USUKA, DEVYN LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:DEVYN
Middle Name:LEE
Last Name:USUKA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-1953
Mailing Address - Country:US
Mailing Address - Phone:570-366-2080
Mailing Address - Fax:
Practice Address - Street 1:123 E MARKET ST
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-1953
Practice Address - Country:US
Practice Address - Phone:570-366-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000104152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist