Provider Demographics
NPI:1932397593
Name:DR. JOSEPH R. WOODLEY, O.D. & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DR. JOSEPH R. WOODLEY, O.D. & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:WOODLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:412-860-9874
Mailing Address - Street 1:157 NASSAU DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-2138
Mailing Address - Country:US
Mailing Address - Phone:412-860-9874
Mailing Address - Fax:724-274-1750
Practice Address - Street 1:2000 VILLAGE CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084
Practice Address - Country:US
Practice Address - Phone:412-860-9874
Practice Address - Fax:724-274-1750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000197152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01887557Medicaid
PA01887557Medicaid
PA085057Medicare PIN