Organization
ANTHONY S. DIECIDUE P.C.
Active
Other names
Eye Associates of Paupack
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JOSEPH GLASNER IV O.D. (PRESIDENT)
(570) 226-2400
Entity
Organization
Contact information
Practice address
2571 RTE 6, SUITE 1, HAWLEY, PA 18428
(570) 226-2400
(570) 226-2401
Mailing address
208 MAIN ST, STROUDSBURG, PA 18360-2575
(570) 226-2400
(570) 226-2401
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002146
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007411850003
—
PA
Enumeration date
12/29/2016
Last updated
12/29/2016
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