Provider Demographics
NPI:1427163245
Name:PUZIO, RAYMOND PETER (OD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:PETER
Last Name:PUZIO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 N PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6109
Mailing Address - Country:US
Mailing Address - Phone:610-565-6306
Mailing Address - Fax:610-565-6493
Practice Address - Street 1:217 N PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:PA
Practice Address - Zip Code:19086-6109
Practice Address - Country:US
Practice Address - Phone:610-565-6306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-002567152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA63076OtherDAVIS VISION
PA50263OtherAETNA
PA001762475Medicaid
PA008039OtherBLUE CROSS
PA91748OtherNVA
PA001762475Medicaid