Individual
DR. TERA LYN UNZICKER-FASSERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
23 S ARCH ST, MILTON, PA 17847-1124
(570) 768-4970
(570) 768-4902
Mailing address
4504 WESTBRANCH HWY, LEWISBURG, PA 17837-6605
(570) 768-4970
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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