Basic Information
| Provider Information | |||||||||
| NPI: | 1336136464 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WINBERRY | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | PAUL | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 KACEY COURT | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175911234 | ||||||||
| FaxNumber: | 7175919112 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 NOBLE BLVD | ||||||||
| Address2: | |||||||||
| City: | CARLISLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170134122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172186656 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2005 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 270A00478900 | NJ | N | Eye and Vision Services Providers | Optometrist | 152W00000X | OET009052 | PA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.