Provider Demographics
NPI:1801848700
Name:SCHOTT, DANIEL E (OD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:SCHOTT
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 1:21 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEGANY
Mailing Address - State:PA
Mailing Address - Zip Code:16743-1334
Mailing Address - Country:US
Mailing Address - Phone:814-642-9408
Mailing Address - Fax:814-642-9484
Practice Address - Street 1:21 WILLOW ST
Practice Address - Street 2:
Practice Address - City:PORT ALLEGANY
Practice Address - State:PA
Practice Address - Zip Code:16743-1334
Practice Address - Country:US
Practice Address - Phone:814-642-9408
Practice Address - Fax:814-642-9484
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001451152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASC1622333OtherHIGHMARK BCBS
PA081296JT3Medicare PIN
PA081296TCUMedicare ID - Type UnspecifiedPROV NETWORK ID
PAV00583Medicare UPIN
PA0214230001Medicare NSC