Provider Demographics
NPI:1629001573
Name:KIRN, DANIEL P (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:KIRN
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 1:2151 LINGLESTOWN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9499
Mailing Address - Country:US
Mailing Address - Phone:717-657-5030
Mailing Address - Fax:
Practice Address - Street 1:2151 LINGLESTOWN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9499
Practice Address - Country:US
Practice Address - Phone:717-657-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000766152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02123201OtherKEYSTONE
PA36920OtherDAVIS VISION
PADA784868OtherCLARITY VISION/OPTICHOICE
PA396530OtherNVA
PA36920OtherDAVIS VISION