Provider Demographics
NPI:1376762195
Name:WARREN OPHTHALMOLOGY ASSOCIATES, CORP.
Entity Type:Organization
Organization Name:WARREN OPHTHALMOLOGY ASSOCIATES, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAFAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHEIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-856-3300
Mailing Address - Street 1:3921 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-4711
Mailing Address - Country:US
Mailing Address - Phone:330-856-3300
Mailing Address - Fax:330-856-4539
Practice Address - Street 1:3921 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-4711
Practice Address - Country:US
Practice Address - Phone:330-856-3300
Practice Address - Fax:330-856-4539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3599T401152W00000X
OH4982T1852152W00000X
OH35079785S207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2877829Medicaid
OH2877829Medicaid