Provider Demographics
NPI:1619948627
Name:MC LAUGHLIN, DONNA BIERNACKI (OD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:BIERNACKI
Last Name:MC LAUGHLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 RIDGE CREST DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1536
Mailing Address - Country:US
Mailing Address - Phone:570-474-9136
Mailing Address - Fax:
Practice Address - Street 1:82 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-3029
Practice Address - Country:US
Practice Address - Phone:570-823-0290
Practice Address - Fax:570-823-8511
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000685152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU33408Medicare UPIN
PA052628Medicare ID - Type Unspecified