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General NPI Number Information
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NPI Number | 1790002905
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Entity Type | Individual
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Provider Name | JENNIFER LYNN MCGRATH O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/21/2020
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Provider Practice Location Address
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Address Line | 391 EVANS CITY ROAD
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City | BUTLER
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State | PA
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Zip | 16001
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Country | US
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Telephone | 724-283-8144
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Fax |
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Provider Business Mailing Address
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Address Line | 285 ESTATES DR
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City | GIBSONIA
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State | PA
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Zip | 15044-9142
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Country | US
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Telephone |
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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 | OEG002318
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License Number State | PA
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