Healthcare Provider Details

I. General information

NPI: 1952740300
Provider Name (Legal Business Name): CASSANDRA ANNE FOX LOZORAITIS O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CASSANDRA ANNE FOX

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 02/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 E MCMURRAY RD
MC MURRAY PA
15317-3419
US

IV. Provider business mailing address

609 E MCMURRAY RD
MC MURRAY PA
15317-3419
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-3930
  • Fax: 724-941-1787
Mailing address:
  • Phone: 724-941-3930
  • Fax: 724-941-1787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG002749
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: