Randecker, Melissa Nancy
Randecker, Melissa Nancy is an sole proprietor health care provider with primary practice located at 930 Bellefonte Ave , Lock Haven PA 17745-2754. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Randecker, Melissa Nancy can be contacted via phone (570) 748-8900.Contact Information
Primary practice address
930 Bellefonte Ave
Lock Haven PA 17745-2754
Phone: (570) 748-8900
Fax: (570) 748-3200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OET08717 | Pennsylvania |
Profile Details
| NPI number | 1164506739 |
|---|---|
| LBN Legal business name | Randecker, Melissa Nancy |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Oct 20th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164506739 | NPPES |
| Pennsylvania | MEDICAID | 1022033460001 |
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