Provider Demographics
NPI:1053363739
Name:GETMAN, MARC GARY (OD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:GARY
Last Name:GETMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1634
Mailing Address - Country:US
Mailing Address - Phone:215-968-0752
Mailing Address - Fax:
Practice Address - Street 1:2788 KNIGHTS RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-3526
Practice Address - Country:US
Practice Address - Phone:215-639-3740
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE005105P152W00000X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGE110336OtherBC/BS
PAPA95105OtherVBA
PA0558581Medicaid
PA2689OtherAETNA/USHC
PA116961OtherEYEMED
PA42776OtherDAVIS VISION
PA391831OtherNVA
PA110336Medicare ID - Type Unspecified
PA2689OtherAETNA/USHC