Individual
JOHN T ANZELMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1060 N CHURCH ST, HAZLETON, PA 18202-1444
(570) 459-9927
(570) 459-9923
Mailing address
423 3RD AVE, SUITE E, KINGSTON, PA 18704-5809
(570) 288-1974
(570) 288-0288
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000326
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014917810005
—
PA
05
—
0014917810006
—
PA
05
—
0014917810007
—
PA
01
—
410044831
PALMETTO GBA-RRMC
PA
Enumeration date
07/29/2005
Last updated
04/29/2020
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