Healthcare Provider Details

I. General information

NPI: 1902084718
Provider Name (Legal Business Name): JOSEPH J. RAGLANI, O.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 12/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 COLUMBIA AVE
VANDERGRIFT PA
15690-1101
US

IV. Provider business mailing address

PO BOX 449
VANDERGRIFT PA
15690-0449
US

V. Phone/Fax

Practice location:
  • Phone: 724-568-2661
  • Fax: 724-567-2340
Mailing address:
  • Phone: 724-568-2661
  • Fax: 724-567-2340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberOEG000683
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. JOSEPH J RAGLANI
Title or Position: OWNER
Credential: O.D.
Phone: 724-568-2661