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General NPI Number Information
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NPI Number | 1598843815
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Entity Type | Individual
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Provider Name | GARY L ROBERTS OD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2151 SHENANGO VALLEY FWY
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City | HERMITAGE
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State | PA
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Zip | 16148-2586
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Country | US
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Telephone | 724-346-5516
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 KING DR
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City | HERMITAGE
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State | PA
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Zip | 16148-2538
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Country | US
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Telephone | 724-981-3010
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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 | OEG000379
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License Number State | PA
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