=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528263894
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PITTSBURGH EYE ASSOCIATES, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3414 MAIN ST
-----------------------------------------------------
City | MUNHALL
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15120-3257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-461-2020
-----------------------------------------------------
Fax | 412-461-4239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3414 MAIN ST
-----------------------------------------------------
City | MUNHALL
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15120-3257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-461-2020
-----------------------------------------------------
Fax | 412-461-4239
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT - OWNER
-----------------------------------------------------
Name | DR. ROXANA F BARAD
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 412-461-2020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number | MD026939E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------