Provider Demographics
NPI:1508978941
Name:HALIGOWSKI, MARION J III (OD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:J
Last Name:HALIGOWSKI
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1 GRANITE POINT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1992
Mailing Address - Country:US
Mailing Address - Phone:610-378-1344
Mailing Address - Fax:610-378-5169
Practice Address - Street 1:770 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7495
Practice Address - Country:US
Practice Address - Phone:717-272-2161
Practice Address - Fax:717-270-0301
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG-001196152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100888525Medicaid
PA100888525Medicaid