MEDICARE: DR. ERICA A HACKER O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WL0500X	Low Vision Rehabilitation Optometrist	OE 008005 T	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OE008005T	OTHER	PW	OPTOMETRIC LICENSE

General Provider Information

NPI Number	:	1285622738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICA A HACKER O.D.

Provider Business Mailing Address
First Line	:	1816 LOCUST ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5920
Country	:	US
Telephone Number	:	412-368-4400
Fax Number	:	412-368-4091

Provider Business Practice Location Address
First Line	:	1800 WEST ST
Second Line	:
City	:	HOMESTEAD
State	:	PA
Zip	:	15120-2578
Country	:	US
Telephone Number	:	412-368-4400
Fax Number	:	412-368-4091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	12/26/2018

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