Provider Demographics
NPI:1598766990
Name:TOOHEY, GEORGE M (OD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:TOOHEY
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 1:419 FALLOWFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1503
Mailing Address - Country:US
Mailing Address - Phone:724-489-9600
Mailing Address - Fax:724-539-1654
Practice Address - Street 1:419 FALLOWFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-1503
Practice Address - Country:US
Practice Address - Phone:724-489-9600
Practice Address - Fax:724-539-1654
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000643152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT0735710Medicaid
PAT093659OtherBLUE CROSS/BLUE SHIELD
PAP00433391OtherRAILROAD MEDICARE PTAN
PA0007357100002Medicaid
PA0007357100001Medicaid
PA0342500001Medicare NSC
PA093659JP9Medicare PIN
PA093659Medicare PIN
PA0007357100002Medicaid