Healthcare Provider Details

I. General information

NPI: 1427091685
Provider Name (Legal Business Name): ROBERT L. STEIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 SHARON NEW CASTLE RD
FARRELL PA
16121-1576
US

IV. Provider business mailing address

390 LINDEN ST
MEADVILLE PA
16335-3026
US

V. Phone/Fax

Practice location:
  • Phone: 724-979-4008
  • Fax: 724-308-6354
Mailing address:
  • Phone: 814-724-5122
  • Fax: 814-724-8276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOS007208L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01503238
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: