Provider Demographics
NPI:1841528155
Name:DIEHL, JOHN M
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:DIEHL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-3160
Mailing Address - Country:US
Mailing Address - Phone:717-632-5558
Mailing Address - Fax:
Practice Address - Street 1:600 CARLISLE ST STE A
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5100
Practice Address - Country:US
Practice Address - Phone:717-632-5558
Practice Address - Fax:717-632-7493
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03408237700000X
156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA27-1242589OtherBUSINESS TAX ID NUMBER