Provider Demographics
NPI:1316966930
Name:BLYMIRE, NED C (OD)
Entity type:Individual
Prefix:DR
First Name:NED
Middle Name:C
Last Name:BLYMIRE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:234 ROSEDALE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:17345-1023
Mailing Address - Country:US
Mailing Address - Phone:717-266-5661
Mailing Address - Fax:717-266-6510
Practice Address - Street 1:234 ROSEDALE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:PA
Practice Address - Zip Code:17345-1023
Practice Address - Country:US
Practice Address - Phone:717-266-5661
Practice Address - Fax:717-266-6510
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE004155P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABL281421OtherHIGHMARK BS
PA02666500OtherCAPITAL BC
PA02666500OtherCAPITAL BC
PAU07752Medicare UPIN