Provider Demographics
NPI:1417996679
Name:TROIA, VINCENT (OD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:TROIA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-1830
Mailing Address - Country:US
Mailing Address - Phone:724-774-8765
Mailing Address - Fax:724-775-9876
Practice Address - Street 1:1100 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-1830
Practice Address - Country:US
Practice Address - Phone:724-774-8765
Practice Address - Fax:724-775-9876
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000667152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA204285950OtherFEDERAL TAX ID
PA1417996679OtherINDIVIDUAL NPI
PA1881614477OtherGROUP NPI
PA1017647740001Medicaid
PA1017647740001Medicaid