Provider Demographics
NPI:1134192073
Name:NEEDLE, TIMOTHY H (OD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:H
Last Name:NEEDLE
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 1:11 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-1714
Mailing Address - Country:US
Mailing Address - Phone:724-887-5820
Mailing Address - Fax:724-887-5825
Practice Address - Street 1:11 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683
Practice Address - Country:US
Practice Address - Phone:724-887-5820
Practice Address - Fax:724-887-5825
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA245604OtherHEALTH AMERICA
PA1659265OtherOPTICHOICE
PANE1650732OtherHIGHMARK BCBS
PA706937OtherUPMC
PA101189725001Medicaid
PA706937OtherUPMC
PA1659265OtherOPTICHOICE