Provider Demographics
NPI:1457442790
Name:PROLEIKA, SUZANNE (OD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:PROLEIKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:PROLEIKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-808-9800
Mailing Address - Fax:570-808-9801
Practice Address - Street 1:1201 OAK ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-3798
Practice Address - Country:US
Practice Address - Phone:570-808-9800
Practice Address - Fax:570-808-9801
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000862152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
152877OtherCOLE
351435OtherHEALTH ASSURANCE
PA001753849Medicaid
080349OtherFIRST PRIORITY
37443OtherAVESIS
196096OtherCLARITY VISION
396812OtherNVA
2018248OtherAETNA HMO
4141OtherDAVIS
13315OtherGEISINGER
27739OtherMES
925107OtherBLOCK VISION
5888543OtherAETNA PPO
8314OtherSPECTERA
080349OtherFIRST PRIORITY
U44825Medicare UPIN