Provider Demographics
NPI:1801931175
Name:PAPPAS, CATHY (OD)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CATHY
Other - Middle Name:PAPPAS
Other - Last Name:BRAVO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2163 CEDARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 CENTER ST
Practice Address - Street 2:SUITE 10
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-1143
Practice Address - Country:US
Practice Address - Phone:440-286-3373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5058152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH201028695OtherUNITED HEALTHCARE, VSP
OH000000334446OtherANTHEM BLUE CROSS BLUE SH
OH0138518Medicaid
OHOH5058OtherCOLE, EYEMED
OH000000334446OtherANTHEM BLUE CROSS BLUE SH
OHU-88094Medicare UPIN