Provider Demographics
NPI:1003884172
Name:UMLAUF, PERRY (OD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:
Last Name:UMLAUF
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 1:92 TUSCARORA ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1667
Mailing Address - Country:US
Mailing Address - Phone:717-232-0845
Mailing Address - Fax:717-232-3294
Practice Address - Street 1:92 TUSCARORA ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1667
Practice Address - Country:US
Practice Address - Phone:717-232-0845
Practice Address - Fax:717-232-3294
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-0006826152W00000X
CO2701152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU60934Medicare UPIN
CO304783Medicare PIN