Provider Demographics
NPI:1780896878
Name:ROBINSON EYE CENTER LLC
Entity type:Organization
Organization Name:ROBINSON EYE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMAKUMAR
Authorized Official - Middle Name:NATARAJAN
Authorized Official - Last Name:GOUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-695-5510
Mailing Address - Street 1:180 IMPERIAL PLAZA DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:IMPERIAL
Mailing Address - State:PA
Mailing Address - Zip Code:15126-9331
Mailing Address - Country:US
Mailing Address - Phone:724-695-5510
Mailing Address - Fax:724-695-8510
Practice Address - Street 1:180 IMPERIAL PLAZA DR
Practice Address - Street 2:SUITE 400
Practice Address - City:IMPERIAL
Practice Address - State:PA
Practice Address - Zip Code:15126-9331
Practice Address - Country:US
Practice Address - Phone:724-695-5510
Practice Address - Fax:724-695-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417220207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01600717586OtherDORAL PROVIDER & LOCATION
PA43030OtherDAVIS
PAPA7220OtherEYEMED COLE
PAPA17220OtherVBA
PA7589430OtherAETNA PPO
PA0019431640001Medicaid
PA3039591OtherAETNA HMO
PA312055OtherUPMC
PA000000142774OtherUNISON
PA000211356OtherHEALTH AM AS ADV
PA001436147OtherHIGHMARK BCBS
PA7732705OtherCIGNA
PA=========OtherVSP
PAPA7220OtherEYEMED COLE
PA=========OtherGREAT WEST HEALTHCARE
PA43030OtherDAVIS
PA065978Medicare ID - Type Unspecified
PA312055OtherUPMC