Healthcare Provider Details

I. General information

NPI: 1316734114
Provider Name (Legal Business Name): KEVIN GRESS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 ARDMORE BLVD STE 150
PITTSBURGH PA
15221-4860
US

IV. Provider business mailing address

2140 ARDMORE BLVD STE 150
PITTSBURGH PA
15221-4860
US

V. Phone/Fax

Practice location:
  • Phone: 412-578-5801
  • Fax:
Mailing address:
  • Phone: 412-578-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG004390
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: