Provider Demographics
NPI:1922038843
Name:EGER EYE GROUP PC
Entity Type:Organization
Organization Name:EGER EYE GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:MISSY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-264-8830
Mailing Address - Street 1:1501 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2051
Mailing Address - Country:US
Mailing Address - Phone:412-264-8830
Mailing Address - Fax:412-269-7766
Practice Address - Street 1:1501 STATE AVE
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2051
Practice Address - Country:US
Practice Address - Phone:412-264-8830
Practice Address - Fax:412-269-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0953664OtherUPMC
185844OtherHEALTH AMERICA
031790Medicare PIN
PA0187250001Medicare NSC
CE1295Medicare PIN
0953664OtherUPMC