Healthcare Provider Details

I. General information

NPI: 1427221472
Provider Name (Legal Business Name): LEWIS A CARRARINI OD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 DAILY AVE
LATROBE PA
15650-2966
US

IV. Provider business mailing address

1933 DAILEY AVE
LATROBE PA
15650-3087
US

V. Phone/Fax

Practice location:
  • Phone: 724-532-3727
  • Fax: 724-532-3728
Mailing address:
  • Phone: 724-532-3727
  • Fax: 724-532-3728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: LEWIS A CARRARINI
Title or Position: PRESIDENT
Credential: OD
Phone: 724-532-3727