Provider Demographics
NPI:1780847483
Name:LAPPEN, JONATHAN BRADLEY (OD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:BRADLEY
Last Name:LAPPEN
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 1:4048 BEECHWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-2618
Mailing Address - Country:US
Mailing Address - Phone:412-421-9274
Mailing Address - Fax:412-421-6308
Practice Address - Street 1:4048 BEECHWOOD BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217
Practice Address - Country:US
Practice Address - Phone:412-421-9274
Practice Address - Fax:412-421-6308
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1562-595T152WC0802X
PAOEG002070152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4R178Medicare PIN