Provider Demographics
NPI:1801800081
Name:WINCEK-BATESON, R L (OD)
Entity type:Individual
Prefix:
First Name:R
Middle Name:L
Last Name:WINCEK-BATESON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LYNN
Other - Last Name:WINCEK-BATESON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:678 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3930
Mailing Address - Country:US
Mailing Address - Phone:724-349-8000
Mailing Address - Fax:
Practice Address - Street 1:678 PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3930
Practice Address - Country:US
Practice Address - Phone:724-349-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072491Medicare PIN
PA5377790001Medicare NSC
PAU96551Medicare UPIN