Provider Demographics
NPI:1952602120
Name:DESMOND, AMY MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:DESMOND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:BARTAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:816 ESTELLE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2135
Mailing Address - Country:US
Mailing Address - Phone:717-898-8878
Mailing Address - Fax:717-898-4679
Practice Address - Street 1:816 ESTELLE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2135
Practice Address - Country:US
Practice Address - Phone:717-898-8878
Practice Address - Fax:717-898-4679
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002439152WV0400X
NJ27OA00627300152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy