Individual
DR. ANTHONY S DIECIDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
208 MAIN ST, STROUDSBURG, PA 18360-2502
(570) 476-1114
(570) 476-9520
Mailing address
208 MAIN ST, STROUDSBURG, PA 18360-2502
(570) 476-1114
(570) 476-9520
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000110
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000110
PA
152WL0500X
Low Vision Rehabilitation Optometrist
OEG000110
PA
152WP0200X
Pediatric Optometrist
OEG000110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
084299
BCBS
PA
Enumeration date
06/27/2005
Last updated
09/09/2011
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