Provider Demographics
NPI:1114138708
Name:HIGHLAND EYE CARE ASSOCIATES INC.
Entity Type:Organization
Organization Name:HIGHLAND EYE CARE ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DECARLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-437-4100
Mailing Address - Street 1:2 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8926
Mailing Address - Country:US
Mailing Address - Phone:724-437-4100
Mailing Address - Fax:724-437-4330
Practice Address - Street 1:2 HIGHLAND PARK DR
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8926
Practice Address - Country:US
Practice Address - Phone:724-437-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041362E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018212230002Medicaid
PAA72593Medicare UPIN
PA043263Medicare ID - Type Unspecified