1992861702 NPI number — CIANFLONE OPTOMETRY, LLC

Table of content: (NPI 1992861702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992861702 NPI number — CIANFLONE OPTOMETRY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CIANFLONE OPTOMETRY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WALK & CIANFLONE, LLC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992861702
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 OLD CLAIRTON ROAD
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:
15236-3916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-653-0277
Provider Business Mailing Address Fax Number:
412-653-1141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
71 OLD CLAIRTON ROAD
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:
15236-3916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-653-0277
Provider Business Practice Location Address Fax Number:
412-653-1141
Provider Enumeration Date:
12/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CIANFLONE
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
OD/OWNER
Authorized Official Telephone Number:
412-653-0277

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OE007120T , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: OEG000981 , 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: 410049770 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 324813 . This is a "UPMC HEALTH PLAN PROVID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CI1417152 . This is a "BCBS FOR DR CIANFLONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: WA634207 . This is a "BCBS FOR DR WALK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 410048930 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1960435 . This is a "BLUE SHIELD MEDICAL PROVI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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