Provider Demographics
NPI:1821346776
Name:VAN DELL, SELINDA LEHNEIS (OD)
Entity Type:Individual
Prefix:
First Name:SELINDA
Middle Name:LEHNEIS
Last Name:VAN DELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SELINDA
Other - Middle Name:ANN
Other - Last Name:LEHNEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1201 W ELM AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-4600
Mailing Address - Country:US
Mailing Address - Phone:717-630-2922
Mailing Address - Fax:717-630-2322
Practice Address - Street 1:1201 W ELM AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-4600
Practice Address - Country:US
Practice Address - Phone:717-630-2922
Practice Address - Fax:717-630-2322
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003979152W00000X
MDTA2779152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC9187KMedicare PIN
NCNC9187CMedicare PIN
NCNC9187GMedicare PIN
NCNC9187HMedicare PIN
NCNC9187BMedicare PIN
NCNC9187JMedicare PIN
NC5922269Medicaid
NCNC9187LMedicare PIN
NCNC9187AMedicare PIN
NCNC9187FMedicare PIN
NC1744XOtherBCBS
NCNC9187EMedicare PIN
NCNC9187DMedicare PIN
NCNC9187IMedicare PIN