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Individual

DR. TERA LYN UNZICKER-FASSERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000436
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1424800
BLUE SHIELD
01
50072024
CAPITAL BLUE
01
822469
FIRST PRIORITY
01
97422
GEISINGER
Enumeration date
12/14/2006
Last updated
01/21/2021
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