Healthcare Provider Details

I. General information

NPI: 1023934577
Provider Name (Legal Business Name): ZACHARY MICHAEL AUSTIN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 STATE AVE
CORAOPOLIS PA
15108-2051
US

IV. Provider business mailing address

1501 STATE AVE
CORAOPOLIS PA
15108-2051
US

V. Phone/Fax

Practice location:
  • Phone: 412-264-8830
  • Fax: 412-269-7766
Mailing address:
  • Phone: 412-264-8830
  • Fax: 412-269-7766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG004385
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: