Provider Demographics
NPI:1205831757
Name:HECKERT, A. GALE (OD)
Entity Type:Individual
Prefix:DR
First Name:A.
Middle Name:GALE
Last Name:HECKERT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3929
Mailing Address - Country:US
Mailing Address - Phone:724-465-4747
Mailing Address - Fax:724-465-8438
Practice Address - Street 1:689 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3929
Practice Address - Country:US
Practice Address - Phone:724-465-4747
Practice Address - Fax:724-465-8438
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001026152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU33285Medicare UPIN
PAHE046641Medicare ID - Type Unspecified