Provider Demographics
NPI:1114968948
Name:DEMKO, STEVEN RAYMOND (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RAYMOND
Last Name:DEMKO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:296 UPPER SWIFTWATER RD
Mailing Address - Street 2:UNIT 212
Mailing Address - City:SWIFTWATER
Mailing Address - State:PA
Mailing Address - Zip Code:18370-5007
Mailing Address - Country:US
Mailing Address - Phone:570-839-2221
Mailing Address - Fax:570-839-2576
Practice Address - Street 1:2 FORK ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MOUNT POCONO
Practice Address - State:PA
Practice Address - Zip Code:18344-1202
Practice Address - Country:US
Practice Address - Phone:570-839-2221
Practice Address - Fax:570-839-2576
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000760152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU01008Medicare UPIN
PA088320Medicare ID - Type Unspecified
PA583099TWEMedicare ID - Type Unspecified