Provider Demographics
NPI:1205012010
Name:DR. DANIEL K . GIFT O.D.
Entity Type:Organization
Organization Name:DR. DANIEL K . GIFT O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:GIFT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-837-0112
Mailing Address - Street 1:423 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-1215
Mailing Address - Country:US
Mailing Address - Phone:570-837-0112
Mailing Address - Fax:
Practice Address - Street 1:423 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:PA
Practice Address - Zip Code:17842-1215
Practice Address - Country:US
Practice Address - Phone:570-837-0112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0362410001Medicare NSC