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NPI Code Detail

MEDICARE: DR. THOMAS M. BARTOLAC O.D.

MEDICARE: DR. THOMAS M. BARTOLAC O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOEG000584PA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2580002452OTHERPAPALMETTO GBA, RAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1406625OTHERPAHIGHMARK BLUECROSS BLUESH
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598725467
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS M. BARTOLAC O.D.
Provider Business Mailing Address
First Line : 8730 NORWIN AVE
Second Line :
City : NORTH HUNTINGDON
State : PA
Zip : 15642-2745
Country : US
Telephone Number : 724-864-7777
Fax Number : 724-864-7779
Provider Business Practice Location Address
First Line : 8730 NORWIN AVE
Second Line :
City : NORTH HUNTINGDON
State : PA
Zip : 15642-2745
Country : US
Telephone Number : 724-864-7777
Fax Number : 724-864-7779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 02/18/2015

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