Provider Demographics
NPI:1104972686
Name:CROUSE, VICTORIA L
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:CROUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 OLD HARRISBURG RD
Mailing Address - Street 2:DBA GETTYSBURG OPTICAL
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8549
Mailing Address - Country:US
Mailing Address - Phone:717-334-8335
Mailing Address - Fax:717-334-8889
Practice Address - Street 1:805 OLD HARRISBURG RD
Practice Address - Street 2:DBA GETTYSBURG OPTICAL
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8549
Practice Address - Country:US
Practice Address - Phone:717-334-8335
Practice Address - Fax:717-334-8889
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4616320001Medicare NSC