Provider Demographics
NPI:1902551765
Name:LOW VISION OPTOMETRY OF CENTRAL PENNSYLVANIA, LLC
Entity Type:Organization
Organization Name:LOW VISION OPTOMETRY OF CENTRAL PENNSYLVANIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YANNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:NACHTIGALL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-968-7302
Mailing Address - Street 1:482 WHEATFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9022
Mailing Address - Country:US
Mailing Address - Phone:717-968-7302
Mailing Address - Fax:
Practice Address - Street 1:482 WHEATFIELD DR
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9022
Practice Address - Country:US
Practice Address - Phone:717-968-7302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty