Provider Demographics
NPI:1063471555
Name:CAKANAC, RANDY J (OD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:J
Last Name:CAKANAC
Suffix:
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 1:8730 NORWIN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2745
Mailing Address - Country:US
Mailing Address - Phone:724-864-7777
Mailing Address - Fax:724-864-7779
Practice Address - Street 1:8730 NORWIN AVE
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-2745
Practice Address - Country:US
Practice Address - Phone:724-864-7777
Practice Address - Fax:724-864-7779
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000880152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1693830Medicaid
PA410041703OtherPALMETTO GBA, RAILROAD MEDICARE
PA569426OtherHIGHMARK BLUECROSS BLUESH
PA569426OtherHIGHMARK BLUECROSS BLUESH
PAU23658Medicare UPIN