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General NPI Number Information
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NPI Number | 1508309600
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Entity Type | Organization
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Legal Business Name | WEST PENN EYE ASSOCIATES
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Dates
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Enumeration Date | 11/22/2016
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 4815 LIBERTY AVE SUITE M-25
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City | PITTSBURGH
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State | PA
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Zip | 15224-2156
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Country | US
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Telephone | 412-621-7038
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Fax | 412-578-1166
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Provider Business Mailing Address
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Address Line | 4815 LIBERTY AVE SUITE M-25
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City | PITTSBURGH
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State | PA
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Zip | 15224-2156
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Country | US
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Telephone | 412-621-7038
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Fax | 412-578-1166
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Authorized Official
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Title or Position | MD
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Name | STEVEN ROGERS
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Credential |
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Telephone | 412-621-7038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD047489L
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License Number State | PA
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