Provider Demographics
NPI:1720046931
Name:NORTH PARK OPHTHALMOLOGY PC
Entity Type:Organization
Organization Name:NORTH PARK OPHTHALMOLOGY PC
Other - Org Name:NORTH PARK OPHTHALMOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-367-2333
Mailing Address - Street 1:5900 CORPORATE DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-7005
Mailing Address - Country:US
Mailing Address - Phone:412-367-2333
Mailing Address - Fax:412-367-3471
Practice Address - Street 1:5900 CORPORATE DR
Practice Address - Street 2:SUITE 150
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-7005
Practice Address - Country:US
Practice Address - Phone:412-367-2333
Practice Address - Fax:412-367-3471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01815692Medicaid
PA01636631OtherBLUE SHIELD
PA01815692Medicaid
PA5254290001Medicare NSC