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Individual

BARBARA WYWIORSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
16 MIX AVE, TOWANDA, PA 18848-1948
(570) 265-8135
(570) 268-8990
Mailing address
16 MIX AVE, TOWANDA, PA 18848-1948
(570) 265-8135
(570) 268-8990

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000523
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014887860003
PA
01
10893
GEISINGER
PA
01
3289060
AETNA
01
816925
FIRST PRIORITY
PA
01
WY1511629
BLUE SHIELD
PA
Enumeration date
07/26/2005
Last updated
11/15/2012
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