Provider Demographics
NPI:1073548822
Name:MCCAFFREY, MICHAEL S (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:MCCAFFREY
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 1:3300 THORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1542
Mailing Address - Country:US
Mailing Address - Phone:412-854-0508
Mailing Address - Fax:412-854-8175
Practice Address - Street 1:6305 LIBRARY RD
Practice Address - Street 2:
Practice Address - City:SOUTH PARK
Practice Address - State:PA
Practice Address - Zip Code:15129-8502
Practice Address - Country:US
Practice Address - Phone:412-854-4130
Practice Address - Fax:412-854-8175
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG00503152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist