Provider Demographics
NPI:1710378427
Name:ALLEGHENY EYE ASSOCIATES LLC
Entity Type:Organization
Organization Name:ALLEGHENY EYE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-335-7799
Mailing Address - Street 1:2800 LEECHBURG RD
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-2527
Mailing Address - Country:US
Mailing Address - Phone:724-335-7799
Mailing Address - Fax:724-335-7794
Practice Address - Street 1:2800 LEECHBURG RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-2527
Practice Address - Country:US
Practice Address - Phone:724-335-7799
Practice Address - Fax:724-335-7794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG002370152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty