1407171028 NPI number — MRS. SARA ELIZABETH STEWART DO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407171028 NPI number — MRS. SARA ELIZABETH STEWART DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEWART
Provider First Name:
SARA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEWART
Provider Other First Name:
SARA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1407171028
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ASSOCIATES IN OPHTHALMOLOGY LIC
Provider Second Line Business Mailing Address:
9970 MOUNTAIN VIEW DRIVE
Provider Business Mailing Address City Name:
WEST MIFFLIN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15122-2476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-653-3080
Provider Business Mailing Address Fax Number:
412-650-8860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ASSOCIATES IN OPHTHALMOLOGY LIC
Provider Second Line Business Practice Location Address:
9970 MOUNTAIN VIEW DRIVE
Provider Business Practice Location Address City Name:
WEST MIFFLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15122-2476
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-653-3080
Provider Business Practice Location Address Fax Number:
412-650-8860
Provider Enumeration Date:
04/07/2010

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: 207R00000X , with the licence number:  58003180 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 58.003180 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207WX0110X , with the licence number: OS017728 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: OS017728 , 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)