Provider Demographics
NPI:1194724807
Name:HOOLAHAN, PAUL J (OD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:HOOLAHAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4812
Mailing Address - Country:US
Mailing Address - Phone:412-321-3444
Mailing Address - Fax:412-466-7906
Practice Address - Street 1:818 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4812
Practice Address - Country:US
Practice Address - Phone:412-321-3444
Practice Address - Fax:412-466-7906
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000666152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010996610008Medicaid
PA301834OtherUPMC HEALTH PLAN
PA4389392OtherAETNA
PA500418OtherHIGHMARK BCBS
PA50539000OtherDAVIS VISION
PA7137896OtherCIGNA
PA1194724807OtherOPTICARE
PAH0500418OtherUMWA
PA0000500418OtherAMERIHEALTH ADMINISTRATOR
PA236729OtherADVANTRA/ HEALTH AMERICA
PA0000500418OtherAMERIHEALTH ADMINISTRATOR
PAH0500418OtherUMWA