SMITH, AMANDA BRANDNER (OD)

Provider Demographics

• NPI: 1912236761
• Name: SMITH, AMANDA BRANDNER (OD)
• Entity Type: Individual
• Prefix: DR
• First Name: AMANDA
• Middle Name: BRANDNER
• Last Name: SMITH
• Gender: F
• Credentials: OD
• Other - Prefix: MRS
• Other - First Name: AMANDA
• Other - Last Name: BRANDNER
• Other - Last Name Type: Other Name
• Other - Credentials: OD
• Mailing Address - Street 1: PO BOX 58
• Mailing Address - City: NASSAU
• Mailing Address - State: DE
• Mailing Address - Zip Code: 19969-0058
• Mailing Address - Country: US
• Mailing Address - Phone: 703-847-8899
• Mailing Address - Fax: 703-991-0514
• Practice Address - Street 1: 28322 LEWES GEORGETOWN HWY
• Practice Address - City: MILTON
• Practice Address - State: DE
• Practice Address - Zip Code: 19968-3117
• Practice Address - Country: US
• Practice Address - Phone: 302-684-2020
• Practice Address - Fax: 302-684-2021
• Is Sole Proprietor?: No
• Enumeration Date: 2009-12-08
• Last Update Date: 2021-01-27

Provider Licenses

State	License ID	Taxonomies
DE	13-0001341	152WV0400X
DE	I3-0001341	152W00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	152W00000X	Eye and Vision Services Providers	Optometrist
No	152WV0400X	Eye and Vision Services Providers	Optometrist	Vision Therapy

Provider Identifiers

State	Identifier ID	ID Type	Issuer
	12078052	Other	CAQH
DE	13-0001341	Other	PROFESSIONAL LICENSE
DE	1982734547	Other	LOCATION NPI FOR HEA MILFORD LOCATION
DE	1932238789	Other	LOCATION NPI FOR HEA SMYRNA LOCATION
	183942H47	Other	MEDICARE PTAN FOR HALPERN MEDICAL SERVICES/HALPERN OPTHAMOLOGY ASSO.
DE	1407986086	Other	LOCATION NPI FOR HEA MILLVILLE OFFICE
	G01047	Other	MEDICARE GROUP PTAN FOR HALPERN MEDICAL SERVICES/HALPERN OPTHAMOLOGY ASSO
	1346430360	Other	MEDICARE GRP NPI FOR HALPERN MEDICAL SERVICES/HALPERN OPTHAMOLOGY ASSO.
DE	P01245270	Other	PALMETTO GBA PTAN RR MEDICARE GRP 1245251313
DE	1275662165	Other	LOCATION NPI FOR HEA BEAR LOCATION
	12078052	Other	CAQH
DE	1710016639	Other	LOCATION NPI FOR HEA MIDDLETOWN OFFICE
DE	1659506723	Other	LOCATION NPI FOR HEA WEST DOVER LOCATION
	G00016	Other	MEDICARE GROUP PIN FOR HALPERN EYE ASSOCIATES, P. A.
DE	1245251313	Other	HALPERN EYE ASSOCIATES, P. A. GROUP NPI
DE	1912236761	Other	INDIVIDUAL NPI
DE	1417087164	Other	LOCATION NPI HALPERN EYE ASSOCIATES-DOVER
DE	1912236761	Other	INDIVIDUAL NPI
DE	1417087164	Other	LOCATION NPI HALPERN EYE ASSOCIATES-DOVER