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Contact Information

ROBERT D BLASE, OD
155 WYOMING AVE
WYOMING, PA18644-1708
 Phone: 570-693-1578
 Fax: 570-693-2010
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ROBERT D BLASE · (Male)

NPI Number 1477513612
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 03/23/2006
Last updated 02/21/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • PA License # OEG000804
  • PA Medicaid 000901188
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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