Healthcare Provider Details
I. General information
NPI: 1427031178
Provider Name (Legal Business Name): STAR OPTICAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1860 CENTRE AVE
PITTSBURGH PA
15219-4369
US
IV. Provider business mailing address
1860 CENTRE AVE
PITTSBURGH PA
15219-4369
US
V. Phone/Fax
- Phone: 412-338-9966
- Fax: 412-338-9969
- Phone: 412-338-9966
- Fax: 412-338-9969
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 156FX1100X |
| Taxonomy | Ophthalmic Technician/Technologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
RILEY
C
DAVIS
Title or Position: OWNER ADMINISTRATION
Credential:
Phone: 724-547-8199