Doctor Name: | MR. WILLIAM P CREVAR |
NPI Number: | 1073596417 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | |
Business Practice Address: | 3519 Homestead Duquesne Rd West Mifflin, PA - 151222910 |
Business Phone Number: | 4124667452 |
Business Fax Number: | 4124667452 |
Mailing Address: | 3519 Homestead Duquesne Rd, WEST MIFFLIN |
State: | PA |
Postal Code: | 151222910 |
Phone Number: | 4124667452 |
Fax Number: | 4124667452 |
NPI Enumeration Date: | 11/21/2005 |
NPI Last Update Date: | 03/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |