Provider Demographics
NPI:1265874721
Name:ZEITLIN, SHANA BARRETT (OD)
Entity type:Individual
Prefix:DR
First Name:SHANA
Middle Name:BARRETT
Last Name:ZEITLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHANA
Other - Middle Name:M
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:806 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:RYDAL
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2313
Mailing Address - Country:US
Mailing Address - Phone:267-518-3032
Mailing Address - Fax:
Practice Address - Street 1:806 BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-2313
Practice Address - Country:US
Practice Address - Phone:267-518-3032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002792152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist