Provider Demographics
NPI:1922100478
Name:WEINBERGER, MARK R (OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:R
Last Name:WEINBERGER
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:2351 CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-2430
Mailing Address - Country:US
Mailing Address - Phone:412-653-9700
Mailing Address - Fax:412-653-9364
Practice Address - Street 1:2351 CENTURY DR
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2430
Practice Address - Country:US
Practice Address - Phone:412-653-9700
Practice Address - Fax:412-653-9364
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2014-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOET-9049152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29727Medicare UPIN