Provider Demographics
NPI:1073298360
Name:HEISS, DAREN MICHAEL II (ABOC)
Entity Type:Individual
Prefix:MR
First Name:DAREN
Middle Name:MICHAEL
Last Name:HEISS
Suffix:II
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 BLAKESLEE BOULEVARD DR E
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-9824
Mailing Address - Country:US
Mailing Address - Phone:570-386-4019
Mailing Address - Fax:570-386-2842
Practice Address - Street 1:1731 BLAKESLEE BOULEVARD DR E
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-9824
Practice Address - Country:US
Practice Address - Phone:570-386-4019
Practice Address - Fax:570-386-2842
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician