Provider Demographics
NPI:1932463585
Name:COCA, MIRCEA N (MD)
Entity Type:Individual
Prefix:
First Name:MIRCEA
Middle Name:N
Last Name:COCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EVERETT & HURITE OPHTHALMIC ASSOCIATION
Mailing Address - Street 2:1835 FORBES AVENUE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5835
Mailing Address - Country:US
Mailing Address - Phone:412-288-0885
Mailing Address - Fax:412-281-1926
Practice Address - Street 1:EVERETT & HURITE OPHTHALMIC ASSOCIATION
Practice Address - Street 2:1835 FORBES AVENUE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5835
Practice Address - Country:US
Practice Address - Phone:412-288-0885
Practice Address - Fax:412-281-1926
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036139999207W00000X
PAMD464061207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103514968Medicaid