Individual
DR. TERENCE MOODY DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 887-3236
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
131307-1
NY
207W00000X
Ophthalmology Physician
Primary
MD028357E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00009003960001
—
PA
05
—
00627770
—
NY
01
—
180040307
RR MEDICARE PIN
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039847
MEDICARE GROUP
PA
01
—
P00258515
RR MEDICARE PIN
NY
Enumeration date
02/21/2006
Last updated
01/09/2019
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