Provider Demographics
NPI:1518179274
Name:GUERIN, RICHARD LEO (OD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEO
Last Name:GUERIN
Suffix:
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 1:2428 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-3637
Mailing Address - Country:US
Mailing Address - Phone:717-612-9544
Mailing Address - Fax:717-730-9420
Practice Address - Street 1:3648 CAPITAL CITY MALL
Practice Address - Street 2:STERLING OPTICAL
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011
Practice Address - Country:US
Practice Address - Phone:717-975-2300
Practice Address - Fax:717-730-9420
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET-008784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist