Provider Demographics
NPI:1316169147
Name:ANDINO, RONALD (OD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:ANDINO
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 1:116 HOWLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2560 DARLINGTON ROAD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010
Practice Address - Country:US
Practice Address - Phone:724-843-2025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001295152W00000X
PAMA0491237152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA459894OtherHIGHMARK - DOCTOR NUMBER
PA25-1326118OtherMISCELLANEOUS INSURANCES
PAAN138222OtherHIGHMARK -ANDINO EYE CARE
PAT-30558Medicare ID - Type UnspecifiedDOCTOR NUMBER
PA25-1326118OtherMISCELLANEOUS INSURANCES
PA459894FX3Medicare PIN