Healthcare Provider Details

I. General information

NPI: 1356789671
Provider Name (Legal Business Name): BETSY LEIGH KAMINSKI O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2013
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 RODI RD STE 1
PITTSBURGH PA
15235-4569
US

IV. Provider business mailing address

5716 HOWE ST APT 1 B
PITTSBURGH PA
15232-2665
US

V. Phone/Fax

Practice location:
  • Phone: 412-256-2020
  • Fax:
Mailing address:
  • Phone: 304-281-5127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG002769
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: