Provider Demographics
NPI:1508471632
Name:DANIEL NEWCOMER III
Entity Type:Organization
Organization Name:DANIEL NEWCOMER III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWCOMER
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:610-266-6666
Mailing Address - Street 1:265 LEHIGH VALLEY MALL
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5719
Mailing Address - Country:US
Mailing Address - Phone:610-266-6666
Mailing Address - Fax:610-266-2984
Practice Address - Street 1:265 LEHIGH VALLEY MALL
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5719
Practice Address - Country:US
Practice Address - Phone:610-266-6666
Practice Address - Fax:610-266-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty