Provider Demographics
NPI:1568547776
Name:FINK- FREEMAN, SANDRA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LYNN
Last Name:FINK- FREEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 EASTERN AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-1100
Mailing Address - Country:US
Mailing Address - Phone:717-597-7708
Mailing Address - Fax:717-597-1052
Practice Address - Street 1:50 EASTERN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-1100
Practice Address - Country:US
Practice Address - Phone:717-597-7708
Practice Address - Fax:717-597-1052
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1535610OtherAETNA HMO
PA188640OtherHEALTH AMERICA
PA5935579OtherAETNA PPO
PAP00408163OtherRAILROAD MEDICARE
PA50064908OtherCAPITAL BLUE CROSS
PA88439OtherBLUE SHIELD
PA088439R1BOtherMEDICARE
PAP00408163OtherRAILROAD MEDICARE