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General NPI Number Information
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NPI Number | 1699091637
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Entity Type | Organization
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Legal Business Name | MARK WEINBERGER OD
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 04/15/2010
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Provider Practice Location Address
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Address Line | 2351 CENTURY DR
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City | WEST MIFFLIN
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State | PA
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Zip | 15122-2430
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Country | US
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Telephone | 412-653-9700
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Fax | 412-653-3964
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Provider Business Mailing Address
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Address Line | 2351 CENTURY DR
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City | WEST MIFFLIN
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State | PA
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Zip | 15122
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Country | US
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Telephone | 412-653-9700
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Fax | 412-653-3964
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MARK R WEINBERGER
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Credential | O.D.
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Telephone | 412-953-3636
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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 | OEG-0503
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OET-9049
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License Number State | PA
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