Provider Demographics
NPI:1790128254
Name:GEISINGER OPHTHALMOLOGY SUNBURY A SERVICE OF GEISINGER MEDICAL CENTER
Entity Type:Organization
Organization Name:GEISINGER OPHTHALMOLOGY SUNBURY A SERVICE OF GEISINGER MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:SOKOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-271-8892
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6211
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:437 MARKET ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-2335
Practice Address - Country:US
Practice Address - Phone:570-286-3054
Practice Address - Fax:570-286-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Multi-Specialty