Provider Demographics
NPI:1326250945
Name:YORKGITIS & GRIENEISEN PC
Entity Type:Organization
Organization Name:YORKGITIS & GRIENEISEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEB
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCLINTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:CPOT
Authorized Official - Phone:717-249-4948
Mailing Address - Street 1:25 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4420
Mailing Address - Country:US
Mailing Address - Phone:717-249-4948
Mailing Address - Fax:717-249-0558
Practice Address - Street 1:25 STATE AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4420
Practice Address - Country:US
Practice Address - Phone:717-249-4948
Practice Address - Fax:717-249-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG000411152W00000X
PA0EG000260152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA410007529OtherRAILROAD MEDICARE
PA410043638OtherRAILROAD MEDICARE
184932Medicare ID - Type UnspecifiedANTHONY J GRIENEISEN OD
PA410043638OtherRAILROAD MEDICARE
T30003Medicare UPIN
T29445Medicare UPIN
PA0505760001Medicare NSC