Provider Demographics
NPI:1235178211
Name:ROBERT RICART OD AND ASSOCIATES
Entity Type:Organization
Organization Name:ROBERT RICART OD AND ASSOCIATES
Other - Org Name:ROBERT N RICART
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTOMETRIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NEFF
Authorized Official - Last Name:RICART
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-454-6517
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000491152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0727940001OtherDMERC A
PA410042506Medicare PIN
PA473949JDGMedicare PIN
PA416583JDGMedicare PIN
PA0727940001OtherDMERC A
PAT30281Medicare UPIN
PA535215Medicare PIN
PARO535215Medicare PIN
PA410036308Medicare PIN