Provider Demographics
NPI:1679907745
Name:JOSEPH SERNIAK, O.D. P.C.
Entity type:Organization
Organization Name:JOSEPH SERNIAK, O.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SERNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-386-4168
Mailing Address - Street 1:717 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:ANDREAS
Mailing Address - State:PA
Mailing Address - Zip Code:18211-3116
Mailing Address - Country:US
Mailing Address - Phone:570-386-4168
Mailing Address - Fax:
Practice Address - Street 1:717 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:ANDREAS
Practice Address - State:PA
Practice Address - Zip Code:18211-3116
Practice Address - Country:US
Practice Address - Phone:570-386-4168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG 002437152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty