Provider Demographics
NPI:1659556066
Name:BAYFRONT EYECARE, P.C.
Entity Type:Organization
Organization Name:BAYFRONT EYECARE, P.C.
Other - Org Name:ROBERT N RICART
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SKADHAUGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-454-6517
Mailing Address - Street 1:300 STATE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1429
Mailing Address - Country:US
Mailing Address - Phone:814-454-6517
Mailing Address - Fax:
Practice Address - Street 1:300 STATE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1429
Practice Address - Country:US
Practice Address - Phone:814-454-6517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA473949XSUMedicare UPIN
PAT30281Medicare PIN
PA416583XSUMedicare UPIN
PAV04325Medicare PIN
PA089261XSUMedicare UPIN
PA0727940001Medicare NSC
PADG8866Medicare PIN
PAT30634Medicare PIN
PA6116650001Medicare NSC