Provider Demographics
NPI:1598066441
Name:PRITZKER, DAVID MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:PRITZKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2899 WHITEFORD RD
Mailing Address - Street 2:SEARS OPTICAL
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-8902
Mailing Address - Country:US
Mailing Address - Phone:717-751-6116
Mailing Address - Fax:717-751-0542
Practice Address - Street 1:2899 WHITEFORD RD
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-8902
Practice Address - Country:US
Practice Address - Phone:717-751-6116
Practice Address - Fax:717-751-0542
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-002042152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005588770006Medicaid
PAT72481Medicare UPIN