=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295628899
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIE LYN FICK OD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2025
-----------------------------------------------------
Last Update Date | 07/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1622 LOCUST ST
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15219-5924
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-438-2619
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8505 SEDONIA CIR
-----------------------------------------------------
City | ESTERO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33967-0548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-561-8551
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OEG004248
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------