Provider Demographics
NPI:1710086814
Name:PUSZ, KRISTINA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:ANN
Last Name:PUSZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:ANN
Other - Last Name:KLESCZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2026 EAST CARSON STREET
Mailing Address - Street 2:SIEGEL PORTNOY EYE CARE ASSOCIATES PC
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203
Mailing Address - Country:US
Mailing Address - Phone:412-381-1542
Mailing Address - Fax:412-381-6662
Practice Address - Street 1:2026 EAST CARSON STREET
Practice Address - Street 2:SIEGEL PORTNOY EYE CARE ASSOCIATES PC
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203
Practice Address - Country:US
Practice Address - Phone:412-381-1542
Practice Address - Fax:412-381-6662
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001682152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102405225-0001Medicaid
PA102405225-0001Medicaid
PAV07033Medicare UPIN
PA095304Medicare ID - Type UnspecifiedMEDICARE NUMBER