Provider Demographics
NPI:1245598978
Name:MEDICAL EYE ASSOCIATES OF PITTSBURGH PC
Entity Type:Organization
Organization Name:MEDICAL EYE ASSOCIATES OF PITTSBURGH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-366-0205
Mailing Address - Street 1:7840 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4301
Mailing Address - Country:US
Mailing Address - Phone:513-354-5808
Mailing Address - Fax:513-354-3774
Practice Address - Street 1:5000 MCKNIGHT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3420
Practice Address - Country:US
Practice Address - Phone:412-366-0205
Practice Address - Fax:412-630-8249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425301207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty