Provider Demographics
NPI:1740692896
Name:JANCARO, DAVID STEPHEN (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:STEPHEN
Last Name:JANCARO
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 1:1041 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014-1301
Mailing Address - Country:US
Mailing Address - Phone:724-972-7877
Mailing Address - Fax:
Practice Address - Street 1:2242 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2308
Practice Address - Country:US
Practice Address - Phone:412-422-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002898152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist