Provider Demographics
NPI:1346325545
Name:FURMAN, TERESA NELL (OD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:NELL
Last Name:FURMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:NELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1201 W ELM AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-4600
Mailing Address - Country:US
Mailing Address - Phone:717-630-2992
Mailing Address - Fax:
Practice Address - Street 1:1201 W ELM AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-4600
Practice Address - Country:US
Practice Address - Phone:717-630-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001404152W00000X
PAOEG003990152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010091489Medicaid
P00152197OtherRAILROAD MEDICARE
VA010091489Medicaid
V01377Medicare UPIN