| Dr David Peter Derose, OD | |
| 
					150 W Hillcrest Dr, Bloomsburg, PA 17815-6710  | |
| (570) 204-6547 | |
| (570) 387-9135 | 
| Full Name | Dr David Peter Derose | 
|---|---|
| Gender | Male | 
| Speciality | Optometrist | 
| Location | 150 W Hillcrest Dr, Bloomsburg, Pennsylvania | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1992814073 | NPI | - | NPPES | 
| 27705 | Other | PA | GEISINGER HEALTH PLAN # | 
| OEG001317 | Other | PA | PA LICENSE NUMBER | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 152W00000X | Optometrist | OEG001317 (Pennsylvania) | Primary | 
| Provider Name | Independence Corporation | 
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice | 
| Provider Identifiers | NPI Number: 1972549657 PECOS PAC ID: 0749351005 Enrollment ID: O20080616000088  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr David Peter Derose, OD 150 W Hillcrest Dr, Bloomsburg, PA 17815-6710 Ph: (570) 204-6547  | Dr David Peter Derose, OD 150 W Hillcrest Dr, Bloomsburg, PA 17815-6710 Ph: (570) 204-6547  | 
Dr. David M. Clark, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 100 Lunger Dr, Bloomsburg, PA 17815 Phone: 570-387-5239  | |
Dr. James Joseph Weyand, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 66 W Hillcrest Dr, Bloomsburg, PA 17815 Phone: 570-594-5028 Fax: 570-387-0832  | |
Nicholas Drobny, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 301 East St, Bloomsburg, PA 17815 Phone: 570-387-8800 Fax: 570-784-8887  | |
Bloom Vision, Llc Optometrist Medicare: Medicare Enrolled Practice Location: 301 East St, Bloomsburg, PA 17815 Phone: 570-387-8800 Fax: 570-784-8887  | |
Dr. Joseph Serniak, OD Optometrist Medicare: Medicare Enrolled Practice Location: 100 Lunger Dr, Bloomsburg, PA 17815 Phone: 570-387-5239 Fax: 570-387-5294  | |
Bogar Vision Care Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 301 East St, Bloomsburg, PA 17815 Phone: 570-387-8800  | |
Dr. Laurie Costarelli, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 301 East St, Bloomsburg, PA 17815 Phone: 570-387-8800 Fax: 570-784-8887  |