DR. GARY LEE DIETTERICK (NPI# 1407836851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407836851 |
| Entity Type | Individual |
| Full Name | DR. GARY LEE DIETTERICK |
| Credential | OD |
| Practice Address |
21 Corporate Dr Ste.#2 Easton PA 18045-2664 |
| Practice Telephone | 6102582442 |
| Practice Fax Number | 6102587965 |
| Mailing Telephone | 6102582442 |
| Mailing Fax Number | 6102587965 |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2008-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OEG000606 | PA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | BLUE SHIELD | 624066 | 01 |
| PA | RR MEDICARE | 180026868 | 01 |
| PA | PALMETTO GBA RR MEDICARE | P00227588 | 01 |
| PA | AETNA# | 3803518 | 01 |
| PA | CAPITAL BC | 01776201 | 01 |
| Street Address |
21 CORPORATE DR STE.#2 |
| City | EASTON |
| State | PA |
| Zip Code | 18045-2664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841293644 | Joel M Brooks | Dentist | 21 Corporate Dr, Ste 5, Easton, PA 18045-2664 | 2005-05-24 |
| 1073054458 | Steward Medical Group Inc. | Clinic/Center | 21 Corporate Dr, Ste. 1, Easton, PA 18045-2664 | 2017-03-17 |
| 1023450582 | Koury Colorectal Associates, P.C. | Colon & Rectal Surgery | 21 Corporate Dr, Suite 6, Easton, PA 18045-2664 | 2013-07-25 |
| 1124216056 | Ashleigh L Crozier | Physician Assistant | 21 Corporate Dr, Suite 1, Easton, PA 18045-2664 | 2007-10-04 |
| 1538299953 | Stanley Robert Walker | Internal Medicine | 21 Corporate Dr, Suite 1, Easton, PA 18045-2664 | 2007-03-06 |
| 1083740344 | Stanley R Walker Mdpc | Internal Medicine | 21 Corporate Dr, Suite 1, Easton, PA 18045-2664 | 2007-02-23 |
| 1700803897 | Gary Lee Dietterick | Optometrist | 21 Corporate Dr, Easton, PA 18045-2664 | 2006-07-16 |
| 1639115751 | Christine H Beck | Rehabilitation Practitioner | 21 Corporate Dr, Suite #6, Easton, PA 18045-2664 | 2006-06-20 |
| 1467412924 | Nirmal Gupta | Podiatrist | 21 Corporate Dr, Suite 3, Easton, PA 18045-2664 | 2006-03-27 |
| 1235121146 | Maheshwer B. Verma | Pediatrics | 21 Corporate Dr, Suite #4, Easton, PA 18045-2664 | 2005-08-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528685492 | Shilpa Salpekar | Internal Medicine | St. Lukes Internal Medicine (easton), 400 S Greenwood Ave, Easton, PA 18045 | 2020-06-26 |
| 1194340224 | Alex Grieco | Internal Medicine | 1700 St. Luke's Blvd., Anderson Medical Education Office, Easton, PA 18045 | 2020-06-15 |
| 1609403112 | Jesse Anderson | Social Worker | 1303c Nicholas St, Easton, PA 18045 | 2020-03-25 |
| 1619538865 | Unknown Azima Shaji | Psychiatry & Neurology | St. Luke's University and Health Network- Anderson, Medical Education Office- 1700, St. Luke's Blvd, Easton, PA 18045 | 2019-06-27 |
| 1679131866 | Kamaldeep Sethi | Family Medicine | 1700 St. Luke's Blvd, Medical Education Office, Easton, PA 18045 | 2019-06-03 |
| 1952849606 | Lehigh Valley Physician Group | Family Medicine | 2401 Northampton St, 1st Floor, Easton, PA 18045 | 2017-02-02 |
| 1760854392 | Dental Professionals of Pennsylvania, PC | Dentist | 4727 Freemansburg Ave, Suite 104, Easton, PA 18045 | 2015-10-22 |
| 1114318870 | Shanthi Narla | Student in an Organized Health Care Education/Training Program | St. Luke's Hospital-anderson Campus, Dermatology, Easton, PA 18045 | 2015-02-16 |
| 1891108718 | Danielle Johnson | Obstetrics & Gynecology | 2200 St. Luke's Blvd, Suite 200, Easton, PA 18045 | 2014-06-09 |
| 1023451085 | Matthew S Yoder | Anesthesiology | 3500 Corriere Rd Apt 100, Easton, PA 18045 | 2013-04-09 |
| Find all providers in zip 18045 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861800 | Shevanie Latchmi Jallim | Optometrist | 3714 Nazareth Rd # 4, Easton, PA 18045-8357 | 2020-11-03 |
| 1306484589 | Alpha Optical Bethlehem, LLC | Optometrist | 4753 Freemansburg Ave, Easton, PA 18045-5529 | 2019-12-18 |
| 1295265734 | Samantha Haslbeck Kravetz | Optometrist | 28522a Marlboro Ave, Easton, MD 21601-2792 | 2017-06-18 |
| 1851842389 | Myeyedr Optometry of Maryland, LLC | Optometrist | 28522 Marlboro Ave, Ste A, Easton, MD 21601 | 2016-10-19 |
| 1548546195 | Professional Eye Associates | Optometrist | 3770 Dryland Way, Suite D600, Easton, PA 18045-8353 | 2011-10-27 |
| 1669641866 | Svetlana Miller | Optometrist | 752 S 25th St, Easton, PA 18042-5337 | 2008-02-21 |
| 1316141864 | Marshalls Creek Vision Center | Optometrist | 145 Palmer Park Mall, Pearle Vision, Easton, PA 18045-2759 | 2007-06-11 |
| 1518003789 | Gary Jon Kokosky | Optometrist | 147 Palmer Park Mall, Easton, PA 18045-2759 | 2007-01-29 |
| 1437236775 | Charles Mcdonald | Optometrist | 220 Marlboro Ave, Tred Avon Square, Easton, MD 21601-2729 | 2006-11-01 |
| 1962510628 | Accurate Optical Co of Easton Inc | Optometrist | 220 Marlboro Rd, Tred Avon Square, Easton, MD 21601 | 2006-08-25 |
| Find all providers in EASTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.