Provider Demographics
NPI:1902841976
Name:LIULIAS, MENELAOS (OD)
Entity Type:Individual
Prefix:DR
First Name:MENELAOS
Middle Name:
Last Name:LIULIAS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 POST RD
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-3334
Mailing Address - Country:US
Mailing Address - Phone:724-612-3711
Mailing Address - Fax:
Practice Address - Street 1:15 PINE GROVE SQ
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4447
Practice Address - Country:US
Practice Address - Phone:724-458-0333
Practice Address - Fax:724-458-0335
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001284152W00000X, 152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2440439OtherUNITED HC
PA1009330680001Medicaid
PA001547685OtherHIGHMARK INDIV
PA001552753OtherHIGHMARK GROUP
TXU86664Medicare UPIN
PA001552753OtherHIGHMARK GROUP