DR. HEATHER ANNE BOURDEAU (NPI# 1851457030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851457030 |
| Entity Type | Individual |
| Full Name | DR. HEATHER ANNE BOURDEAU |
| Credential | O.D. |
| Practice Address |
1130 South 19th Street Harrisburg PA 17104 |
| Practice Telephone | 7172382531 |
| Practice Fax Number | 7172380710 |
| Mailing Telephone | 7172382531 |
| Mailing Fax Number | 7172380710 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2016-12-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 4373-TP | MA | Eye and Vision Services Providers |
| N | 152WL0500X |
Optometrist Specialization: Low Vision Rehabilitation |
4373-TP | MA | Eye and Vision Services Providers |
| N | 152WP0200X |
Optometrist Specialization: Pediatrics |
4373-TP | MA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0323501 | 05 | |
| MA | HARVARD PILGRIM | AA85035 | 01 |
| MA | AETNA | 7940836 | 01 |
| MA | BC/BS | W16497 | 01 |
| Street Address |
1130 SOUTH 19TH STREET |
| City | HARRISBURG |
| State | PA |
| Zip Code | 17104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531292 | Siddharth Goel | Internal Medicine | 205 S Front St Upmc Pinnacle, Internal Medicine Residen, Suite 3c, Harrisburg, PA 17104 | 2020-06-03 |
| 1114541364 | Kolsoum Yari | Student in an Organized Health Care Education/Training Program | 205 S Front St, Suite 3c Upmc Pinnacle Internal Medicin, Harrisburg, PA 17104 | 2020-06-03 |
| 1225652696 | Uba Chinyere Udeh | Internal Medicine | 205 S Front St. Suite 3c, Harrisburg, PA 17104 | 2020-06-02 |
| 1568086932 | Firdausi Abubakar Matawalle | Student in an Organized Health Care Education/Training Program | 205 S Front Street, Suite 3c Upmc Pinnacle Hospital, Harrisburg, PA 17104 | 2020-06-02 |
| 1467075853 | Medhavi Rajput | Student in an Organized Health Care Education/Training Program | 205 S Front St, Suite 3c Upmc Pinnacle, Internal Medici, Harrisburg, PA 17104 | 2020-05-20 |
| 1659992147 | Manpreet Sidhu | Internal Medicine | Upmc Pinnacle Hospitals 205 S Front Street, Suite 3c, Harrisburg, PA 17104 | 2020-05-06 |
| 1336760230 | Mahaswi Sirangi | Internal Medicine | Upmc Pinnacle Hospitals, 205 S Front Street, Suite 3c, Harrisburg, PA 17104 | 2020-05-01 |
| 1033748488 | Abhishek Patel | Emergency Medicine | 205 South Front Street Brady 3, Harrisburg, PA 17104 | 2020-04-07 |
| 1306496443 | Jinah Kim | Student in an Organized Health Care Education/Training Program | 205 S. Front St., Brady Building, Harrisburg, PA 17104 | 2019-09-19 |
| 1356903744 | Krupa Patel | Podiatrist | 205 S Front Street Brady Hall 905, Harrisburg, PA 17104 | 2019-07-05 |
| Find all providers in zip 17104 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043692171 | Danielle Nicole Renda | Optometrist | Route 22 and Colonial Rd, Suite 74, Harrisburg, PA 17109-6235 | 2015-06-25 |
| 1952666406 | Chantel Nicole Garcia Tarbett | Optometrist | 4350 Main St Ste 107, Harrisburg, NC 28075-7439 | 2012-07-11 |
| 1225348899 | Ashley Dominique Hudson | Optometrist | Route 22 and Colonial Rd., Suite 74, Harrisburg, PA 17109 | 2010-10-18 |
| 1699941963 | Christine E. Gavett | Optometrist | 13020 N Route E, Harrisburg, MO 65256 | 2008-05-06 |
| 1225234453 | John D Boer | Optometrist | 220 S Cliff Ave Ste 102, Harrisburg, SD 57032-2117 | 2007-06-25 |
| 1972626935 | David J Bryden | Optometrist | 6021 Allentown Blvd, Harrisburg, PA 17112-2602 | 2007-04-06 |
| 1407998982 | Kimberly A Zimmerman | Optometrist | 2745 N Front St, Harrisburg, PA 17110-1265 | 2007-02-13 |
| 1063569036 | Optometry Associates, P.C. | Optometrist | 4392 Sturbridge Drive, Harrisburg, PA 17110-3670 | 2007-01-04 |
| 1932263738 | Darcy L Williams | Optometrist | 4240 Elmerton Ave, Harrisburg, PA 17109-2317 | 2006-12-19 |
| 1306919097 | Angela Marie Chango-holt | Optometrist | Route 22 & Colonial Road, Colonial Park Mall, Harrisburg, PA 17109-6234 | 2006-11-17 |
| Find all providers in HARRISBURG | ||||
| City | HARRISBURG |
| Zip Code | 17104 |
Please comment or provide details below to improve the information on DR. HEATHER ANNE BOURDEAU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.