Healthcare Provider Details

I. General information

NPI: 1467428144
Provider Name (Legal Business Name): ROBERT E KAMINSKI O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 RODI RD SUITE 100
PITTSBURGH PA
15235-4525
US

IV. Provider business mailing address

645 RODI RD SUITE 100
PITTSBURGH PA
15235-4525
US

V. Phone/Fax

Practice location:
  • Phone: 412-256-2020
  • Fax: 412-247-4963
Mailing address:
  • Phone: 412-256-2020
  • Fax: 412-247-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000366
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: