Provider Demographics
NPI:1013003474
Name:HARTSOCK, ROBERT JOSEPH JR (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:HARTSOCK
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CAMDEN CT
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2331
Mailing Address - Country:US
Mailing Address - Phone:412-398-5565
Mailing Address - Fax:412-494-9759
Practice Address - Street 1:1000 ROBINSON CENTER DR
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4828
Practice Address - Country:US
Practice Address - Phone:412-490-0988
Practice Address - Fax:412-494-9759
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE-007169-T152W00000X
VA0601001706152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01798635Medicaid
PA696201HAOtherBLUE CROSS/BLUE SHIELD
PA397125OtherNATIONAL VISION ADMINISTR
PA696201HAOtherBLUE CROSS/BLUE SHIELD
PAU31501Medicare UPIN