Provider Demographics
NPI:1932241890
Name:JUSTIN, JOEL S (OD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:S
Last Name:JUSTIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:132 S HILLS VLG
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1410
Mailing Address - Country:US
Mailing Address - Phone:412-831-5250
Mailing Address - Fax:412-831-3087
Practice Address - Street 1:132 S HILLS VLG
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1410
Practice Address - Country:US
Practice Address - Phone:412-831-5250
Practice Address - Fax:412-831-3087
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET-008984152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT-27024Medicare UPIN
OHJU0501123Medicare UPIN