MEDICARE: CHRISTOPHER J DALDINE, P.C.

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
1	152W00000X	Optometrist	OEG002776	PA

General Provider Information

NPI Number	:	1972911006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER J DALDINE, P.C.

Provider Business Mailing Address
First Line	:	105 FALL RUN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-3747
Country	:	US
Telephone Number	:	586-354-3225
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 ROUTE 228
Second Line	:	TARGET OPTICAL
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-5312
Country	:	US
Telephone Number	:	724-778-9010
Fax Number	:	724-778-9012

Authorized Official
Title or Position	:	OPTOMETRIST OWNER PRESIDENT
Name	:	DR. CHRISTOPHER JOSEPH DALDINE
Credential	:	O.D.
Telephone Number	:	586-354-3225

Provider Enumeration Date	:	08/01/2014
Last Update Date	:	08/01/2014

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