Provider Demographics
NPI:1427221472
Name:LEWIS A CARRARINI OD INC
Entity Type:Organization
Organization Name:LEWIS A CARRARINI OD INC
Other - Org Name:LATROBE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARRARINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-532-3727
Mailing Address - Street 1:1933 DAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3087
Mailing Address - Country:US
Mailing Address - Phone:724-532-3727
Mailing Address - Fax:724-532-3728
Practice Address - Street 1:1933 DAILY AVE
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2966
Practice Address - Country:US
Practice Address - Phone:724-532-3727
Practice Address - Fax:724-532-3728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOEG000293OtherLICENSE
PA0015171800005Medicaid