Provider Demographics
NPI:1518183714
Name:LAURIE A. ROBA MD LLC
Entity Type:Organization
Organization Name:LAURIE A. ROBA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-963-0414
Mailing Address - Street 1:103 BUCKINGHAM RD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-1505
Mailing Address - Country:US
Mailing Address - Phone:412-963-0414
Mailing Address - Fax:412-963-7066
Practice Address - Street 1:1326 FREEPORT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3131
Practice Address - Country:US
Practice Address - Phone:412-963-0414
Practice Address - Fax:412-963-7066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2007-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044277L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF29426Medicare UPIN