Provider Demographics
NPI:1407852296
Name:TEMNYKH, AMANDA GEORGIANN (OD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:GEORGIANN
Last Name:TEMNYKH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:GEORGIANN
Other - Last Name:ROCKOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:211 PINE HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:PENNSYLVANIA FURNACE
Mailing Address - State:PA
Mailing Address - Zip Code:16865-9560
Mailing Address - Country:US
Mailing Address - Phone:814-692-4853
Mailing Address - Fax:570-892-8465
Practice Address - Street 1:167 HOGAN BLVD
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-1902
Practice Address - Country:US
Practice Address - Phone:570-893-8286
Practice Address - Fax:570-893-8465
Is Sole Proprietor?:No
Enumeration Date:2005-06-26
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist