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General NPI Number Information
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NPI Number | 1740692896
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Entity Type | Individual
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Provider Name | DAVID STEPHEN JANCARO O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 05/23/2014
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Provider Practice Location Address
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Address Line | 2242 MURRAY AVE
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City | PITTSBURGH
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State | PA
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Zip | 15217-2308
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Country | US
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Telephone | 412-422-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 9TH AVE
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City | BRACKENRIDGE
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State | PA
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Zip | 15014-1301
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Country | US
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Telephone | 724-972-7877
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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 | OEG002898
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License Number State | PA
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