Provider Demographics
NPI:1669117982
Name:KELSEY A JANCARO OD LLC
Entity type:Organization
Organization Name:KELSEY A JANCARO OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:JANCARO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-283-2500
Mailing Address - Street 1:261 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1313
Mailing Address - Country:US
Mailing Address - Phone:724-283-2500
Mailing Address - Fax:724-283-1602
Practice Address - Street 1:261 SUNSET DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1313
Practice Address - Country:US
Practice Address - Phone:724-283-2500
Practice Address - Fax:724-283-1602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty