1164573838 NPI number — MR. GEORGE A BITTEL

Table of content: MR. GEORGE A BITTEL (NPI 1164573838)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164573838 NPI number — MR. GEORGE A BITTEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BITTEL
Provider First Name:
GEORGE
Provider Middle Name:
A
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OPTICIANS
Provider Other First Name:
BITTEL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1164573838
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
669 WASHINGTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15228-1902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-563-1020
Provider Business Mailing Address Fax Number:
412-563-6124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
669 WASHINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15228-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-563-1020
Provider Business Practice Location Address Fax Number:
412-563-6124
Provider Enumeration Date:
01/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 42702 . This is a "DAVIS VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017437 . This is a "DORAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018643100001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4377100001 . This is a "MEDICARE-DMERC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: BI225298 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com