Provider Demographics
NPI:1760475941
Name:HEIN, ANNE MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:HEIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11279 PERRY HIGHWAY
Mailing Address - Street 2:SUITE 309
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:724-940-0150
Mailing Address - Fax:724-940-0244
Practice Address - Street 1:11279 PERRY HIGHWAY
Practice Address - Street 2:SUITE 309
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:724-940-0150
Practice Address - Fax:724-940-0244
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA 0EG001185152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0139769015Medicaid
36437Medicare UPIN
PA180752G7PMedicare ID - Type Unspecified