Provider Demographics
NPI:1194794974
Name:NACHTIGALL, YANNA K (OD)
Entity type:Individual
Prefix:DR
First Name:YANNA
Middle Name:K
Last Name:NACHTIGALL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 EASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2906
Mailing Address - Country:US
Mailing Address - Phone:717-757-7023
Mailing Address - Fax:717-747-0123
Practice Address - Street 1:2700 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2906
Practice Address - Country:US
Practice Address - Phone:717-757-7023
Practice Address - Fax:717-747-0123
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001539152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1640779OtherBLUE SHIELD
PA0165770002OtherDMERC REGION D
PA50057686OtherBLUE CROSS
PA084986Medicare PIN
PA50057686OtherBLUE CROSS