Healthcare Provider Details

I. General information

NPI: 1043701964
Provider Name (Legal Business Name): LOOK EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2018
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ROSS PARK MALL DR # N01-H
PITTSBURGH PA
15237-3875
US

IV. Provider business mailing address

1000 ROSS PARK MALL DR # N01H
PITTSBURGH PA
15237-3875
US

V. Phone/Fax

Practice location:
  • Phone: 304-906-0510
  • Fax:
Mailing address:
  • Phone: 412-447-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number223485
License Number State

VIII. Authorized Official

Name: MR. JERRY J GAO
Title or Position: ABOC
Credential: OPTICIAN
Phone: 412-447-8888