Provider Demographics
NPI:1982693255
Name:RESLER, EDWARD A (OD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:A
Last Name:RESLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-1440
Mailing Address - Country:US
Mailing Address - Phone:814-677-3022
Mailing Address - Fax:814-676-8633
Practice Address - Street 1:112 CENTER ST
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-1440
Practice Address - Country:US
Practice Address - Phone:814-677-3022
Practice Address - Fax:814-676-8633
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE004538P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0414270001Medicare NSC
PA287388Medicare PIN