Individual
DR. MARK VINCENT GRAYTOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001356
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011668350003
—
PA
01
—
2090347
AETNA
PA
01
—
250860
VPMC
PA
01
—
251638621
UNITED HEALTHCARE
PA
01
—
533151
HIGHMARK BCBS
PA
01
—
54317
HEALTH AMERICA HEATH ASS
PA
Enumeration date
02/01/2006
Last updated
06/28/2013
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