Provider Demographics
NPI:1952393340
Name:ALLEGHENY OPHTHALMOLOGY INC
Entity Type:Organization
Organization Name:ALLEGHENY OPHTHALMOLOGY INC
Other - Org Name:ALLEGHENY OPHTHALMOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-224-4240
Mailing Address - Street 1:2853 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1905
Mailing Address - Country:US
Mailing Address - Phone:724-224-4240
Mailing Address - Fax:724-224-3197
Practice Address - Street 1:2853 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1905
Practice Address - Country:US
Practice Address - Phone:724-224-4240
Practice Address - Fax:724-224-3197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1132541Medicaid
PA1132541Medicaid