Provider Demographics
NPI:1033196472
Name:SEYLAR, CORY LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:LYNN
Last Name:SEYLAR
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 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:494 GATEWAY AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-7351
Practice Address - Country:US
Practice Address - Phone:717-263-6186
Practice Address - Fax:717-263-6888
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000873152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015389300008Medicaid
MD406230200Medicaid
PA1011733040002Medicaid
MD402812100Medicaid
PAP00065384OtherRAILROAD MEDICARE
PACG7940OtherRAILROAD MEDICARE
MDCG7940OtherRAILROAD MEDICARE
MD523MH035Medicare PIN
PA064401Medicare PIN
PA1303520001Medicare NSC
MD523MMedicare PIN