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General NPI Number Information
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NPI Number | 1205141249
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Entity Type | Individual
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Provider Name | KRYSTAL WEISSERT BAKER O.D
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Gender | Female
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Dates
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Enumeration Date | 08/14/2010
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 223 4TH AVE STE 100
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City | PITTSBURGH
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State | PA
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Zip | 15222-1713
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Country | US
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Telephone | 412-281-7022
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Fax | 412-261-1780
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Provider Business Mailing Address
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Address Line | 3881 ANDERSON RD
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City | GIBSONIA
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State | PA
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Zip | 15044-9412
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG002372
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License Number State | PA
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