Provider Demographics
NPI:1952324014
Name:LAMBERT, BRIAN K (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:K
Last Name:LAMBERT
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 1:1205 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:15066-1634
Mailing Address - Country:US
Mailing Address - Phone:724-843-2883
Mailing Address - Fax:724-843-3648
Practice Address - Street 1:1205 PENN AVE
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:PA
Practice Address - Zip Code:15066-1634
Practice Address - Country:US
Practice Address - Phone:724-843-2883
Practice Address - Fax:724-843-3648
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE 0006428P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5136672OtherAETNA
PA0015141240002OtherACCESS (DPW)
PAT72938Medicare UPIN
PALA459382Medicare ID - Type Unspecified