Basic Information
Provider Information
NPI: 1033887666
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEED
FirstName: SABRINA
MiddleName: KAYLA
NamePrefix:  
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 N ACADEMY AVE
Address2:  
City: DANVILLE
State: PA
PostalCode: 178224903
CountryCode: US
TelephoneNumber: 5702716144
FaxNumber: 5702716578
Practice Location
Address1: 42 N MAIN ST
Address2:  
City: PITTSTON
State: PA
PostalCode: 186401916
CountryCode: US
TelephoneNumber: 5706540880
FaxNumber: 5706559857
Other Information
ProviderEnumerationDate: 08/30/2021
LastUpdateDate: 08/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XOEG003849PAY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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