Provider Demographics
NPI:1851480750
Name:NEAL, AMY M (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:NEAL
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:74 WELWOOD AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-1577
Mailing Address - Country:US
Mailing Address - Phone:570-226-1300
Mailing Address - Fax:570-226-3800
Practice Address - Street 1:74 WELWOOD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-1577
Practice Address - Country:US
Practice Address - Phone:570-226-1300
Practice Address - Fax:570-226-3800
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG000398152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050260Medicare ID - Type Unspecified
U86478Medicare UPIN