Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG001434 | PA |
NPI | 1003952359 |
---|---|
Provider Name | Mrs. Donna Louise Cristiano |
First Address | West Chester, PA 19380-3837 |
Second Address | Temple, PA 19560-1249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |