Provider Demographics
NPI:1255131231
Name:CHILINGUERIAN, HARRY
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:CHILINGUERIAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 N HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1405
Mailing Address - Country:US
Mailing Address - Phone:717-542-1224
Mailing Address - Fax:
Practice Address - Street 1:112 N HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1405
Practice Address - Country:US
Practice Address - Phone:717-542-1224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1101X, 156FX1202X
KY158466156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant
No156FX1202XEye and Vision Services ProvidersTechnician/TechnologistOptometric Technician