Provider Demographics
NPI:1093758112
Name:RICART, ROBERT NEFF (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEFF
Last Name:RICART
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 1:300 STATE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1427
Mailing Address - Country:US
Mailing Address - Phone:814-454-6517
Mailing Address - Fax:814-454-0604
Practice Address - Street 1:300 STATE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1427
Practice Address - Country:US
Practice Address - Phone:814-454-6517
Practice Address - Fax:814-454-0604
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000491152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADG8866OtherR.R. MEDICARE
PA0727940001Medicare NSC
PA416583XSUMedicare UPIN
PADG8866Medicare PIN
PA410036308Medicare PIN
PA416583JDGMedicare PIN