Provider Demographics
NPI:1386658805
Name:GEISER, HERBERT L JR (OD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:L
Last Name:GEISER
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MADISON AVE N-6
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-4873
Mailing Address - Country:US
Mailing Address - Phone:215-672-7766
Mailing Address - Fax:215-672-3688
Practice Address - Street 1:1 MADISON AVE
Practice Address - Street 2:SUITE N-6
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4873
Practice Address - Country:US
Practice Address - Phone:215-672-7766
Practice Address - Fax:215-672-3688
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
30484OtherGVA
44379OtherDAVIS VISION
PA04446OtherVBA
0023521000OtherKEYSTONE
10807OtherSPECTERA
3611OtherAETNA
930864OtherEYE MED
PA04446OtherVBA
0023521000OtherKEYSTONE
U08006Medicare UPIN
30484OtherGVA