Provider Demographics
NPI:1649239526
Name:DRUMMOND-ECK, MARY (OD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:DRUMMOND-ECK
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 1:401 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STOCKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18083-7004
Mailing Address - Country:US
Mailing Address - Phone:610-599-6220
Mailing Address - Fax:610-599-6218
Practice Address - Street 1:327 BLUE VALLEY DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-1526
Practice Address - Country:US
Practice Address - Phone:610-599-6220
Practice Address - Fax:610-599-6218
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET009092152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA410042667OtherRAILROAD MEDICARE
PA1880117Medicaid
PA2127593OtherAETNA
PW653848OtherHIGHMARK BLUE SHIELD
PA50000937OtherCAPITAL BLUE CROSS
PA653848Medicare ID - Type Unspecified
PA2127593OtherAETNA