Provider Demographics
NPI:1083681779
Name:GETTY, JOEL T (OD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:T
Last Name:GETTY
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 1:1384 RED HILL RD
Mailing Address - Street 2:
Mailing Address - City:PORT TREVORTON
Mailing Address - State:PA
Mailing Address - Zip Code:17864-9694
Mailing Address - Country:US
Mailing Address - Phone:570-765-8284
Mailing Address - Fax:
Practice Address - Street 1:247 BROAD ST
Practice Address - Street 2:
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-2283
Practice Address - Country:US
Practice Address - Phone:570-329-0188
Practice Address - Fax:570-329-0190
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG001750152W00000X
NY006873152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist