Provider Demographics
NPI:1982630646
Name:GEORGE J GRISNIK
Entity Type:Organization
Organization Name:GEORGE J GRISNIK
Other - Org Name:WESTMORELAND EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GRISNIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:412-233-3225
Mailing Address - Street 1:502 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-2084
Mailing Address - Country:US
Mailing Address - Phone:412-233-3225
Mailing Address - Fax:412-233-5140
Practice Address - Street 1:502 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-2084
Practice Address - Country:US
Practice Address - Phone:412-233-3225
Practice Address - Fax:412-233-5140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000759152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0240420001Medicare NSC
PA032501Medicare PIN