Provider Demographics
NPI:1407036718
Name:FLAHERTY & CO OPTICIANS
Entity Type:Organization
Organization Name:FLAHERTY & CO OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FLAHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-621-6027
Mailing Address - Street 1:3402 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3205
Mailing Address - Country:US
Mailing Address - Phone:412-621-6027
Mailing Address - Fax:412-621-4047
Practice Address - Street 1:3402 5TH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3205
Practice Address - Country:US
Practice Address - Phone:412-621-6027
Practice Address - Fax:412-621-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017317430001Medicaid