MARY A DESANDO (NPI# 1417969528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417969528 |
| Entity Type | Individual |
| Full Name | MARY A DESANDO |
| Credential | OD |
| Practice Address |
150 Brooklyn St Carbondale PA 18407 |
| Mailing Address |
200 Mifflin Ave Scranton PA 18503 |
| Practice Telephone | 5702827188 |
| Practice Fax Number | 5702824402 |
| Mailing Telephone | 5703423145 |
| Mailing Fax Number | 5703441309 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OEG000527 | PA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 410024727 | 01 | |
| AETNA | 506554 | 01 | |
| GEISINGER HEALTH PLAN | 20969 | 01 | |
| PA | 001163415 | 05 | |
| FIRST PRIORITY HEALTH | 073339 | 01 | |
| HIGH MARK BLUE SHIELD | DE567588 | 01 |
| Street Address |
150 BROOKLYN ST |
| City | CARBONDALE |
| State | PA |
| Zip Code | 18407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770550766 | Frank M Moro | Internal Medicine | 150 Brooklyn St, Carbondale, PA 18407-2274 | 2006-03-08 |
| 1376735571 | Jamie A Hopkins | Family Medicine | 150 Brooklyn St, Carbondale, PA 18407-2274 | 2007-08-13 |
| 1730295056 | Optical Nei Inc | Eyewear Supplier (Equipment, not the service) | 150 Brooklyn St, Carbondale, PA 18407-2274 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761784 | Ashley Ettinger | Counselor | 38 North Scott Road, Carbondale, PA 18407 | 2020-02-12 |
| 1639723109 | Dana Marie Marmo | Counselor | 141 Salem Ave Suite 104, Carbondale, PA 18407 | 2019-08-01 |
| 1831694991 | William Vitzakovitch | Physical Therapist | 504 1/2 Scranton Carbondale Hwy, Mayfield, PA 18407 | 2018-03-29 |
| 1205345014 | The Young Men's Christian Association of Carbondale | Health Educator | 82 N Main Street, Carbondale, PA 18407 | 2017-09-25 |
| 1942722327 | Jamee Ruddy | Early Intervention Provider Agency | 77 Jefferson Street, Simpson, PA 18407 | 2017-07-07 |
| 1417181082 | Paul Erik Larson | Specialist/Technologist | 101 Brooklyn Street/business Route 6, Carbondale, PA 18407 | 2009-05-11 |
| 1316061708 | Christine Marie Roberts | Occupational Therapist | Carbondale Nursing Home, 10 Hart Place, Carbondale, PA 18407 | 2007-03-19 |
| 1407944036 | Brian John Piatak | Chiropractor | 30 N Scott Street, Carbondale, PA 18407 | 2006-10-10 |
| 1427556133 | Brianna Marie Bennici | Occupational Therapy Assistant | 45 N Scott St, Carbondale, PA 18407 | 2018-01-28 |
| 1144632332 | Dannielle S Hafler | Social Worker | 32 N Main St, Carbondale, PA 18407 | 2014-05-22 |
| Find all providers in zip 18407 | ||||
| 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 |
|---|---|---|---|---|
| 1558914150 | Kennon Cox | Optometrist | 1241 E Walnut St, Carbondale, IL 62901-5005 | 2019-07-23 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| 1669680229 | Timothy J Bauer Dr of Optometry Professional Corporation Carbondale | Optometrist | 59 N 4th St, Carbondale, CO 81623-2011 | 2007-05-18 |
| 1467548016 | John F Wood | Optometrist | 1450 E. Main, Carbondale, IL 62901 | 2006-10-04 |
| 1699703421 | Andrews A. White | Optometrist | 1150 Hwy 133, Carbondale, CO 81623 | 2006-06-29 |
| 1942202064 | Sharon Saum Burruss | Optometrist | 1241 E Walnut, Carbondale, IL 62901 | 2005-06-01 |
| 1518316694 | Bradley Dominick Sparks | Optometrist | 30 N Church St, Carbondale, PA 18407-1905 | 2016-06-08 |
| 1649557901 | Barthramod Inc | Optometrist | 59 N 4th St, Carbondale, CO 81623-2011 | 2011-11-14 |
| 1437342284 | Andrews A White Od PC | Optometrist | 1150 Hwy 133, Carbondale, CO 81623 | 2007-08-24 |
| 1639243306 | David Arthur Eberhardt | Optometrist | 59 N 4th St, Carbondale, CO 81623-2011 | 2006-11-17 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 18407 |
Please comment or provide details below to improve the information on MARY A DESANDO.
| 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.