Provider Demographics
NPI:1093983678
Name:GREGORY A. ANOIA. O.D.
Entity Type:Organization
Organization Name:GREGORY A. ANOIA. O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANOIA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-944-3201
Mailing Address - Street 1:120 WEST WATER STREET
Mailing Address - Street 2:BOX 160
Mailing Address - City:MIDDLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17057-1123
Mailing Address - Country:US
Mailing Address - Phone:717-944-3201
Mailing Address - Fax:717-944-5686
Practice Address - Street 1:120 WEST WATER STREET
Practice Address - Street 2:BOX 160
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-1123
Practice Address - Country:US
Practice Address - Phone:717-944-3201
Practice Address - Fax:717-944-5686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000881332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4033500001Medicare NSC