Diecidue, Anthony S
Diecidue, Anthony S is an individual health care provider with primary practice located at 208 Main St , Stroudsburg PA 18360-2502. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Diecidue, Anthony S can be contacted via phone (570) 476-1114.Contact Information
Primary practice address
208 Main St
Stroudsburg PA 18360-2502
Phone: (570) 476-1114
Fax: (570) 476-9520
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Eye and Vision Services Providers / Optometrist | 152W00000X | OEG000110 | Pennsylvania |
Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OEG000110 | Pennsylvania |
Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | OEG000110 | Pennsylvania |
Eye and Vision Services Providers / Pediatrics | 152WP0200X | OEG000110 | Pennsylvania |
Profile Details
NPI number | 1285630996 |
---|---|
LBN Legal business name | Diecidue, Anthony S |
Credentials | Doctor of Optometry (OD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 27th, 2005 |
Last updated | Sep 9th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1285630996 | NPPES |
Pennsylvania | Other | 084299 | BCBS |
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