Provider Demographics
NPI:1457302044
Name:KNORR-PETERS, REBECCA LYNN (OD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:KNORR-PETERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2005
Mailing Address - Country:US
Mailing Address - Phone:412-881-4242
Mailing Address - Fax:412-881-4252
Practice Address - Street 1:51 E WHEELING ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4803
Practice Address - Country:US
Practice Address - Phone:724-225-6050
Practice Address - Fax:724-225-0890
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000117152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU71797Medicare UPIN
PA014220WDOMedicare PIN