Provider Demographics
NPI:1336396159
Name:ADVANCED OPHTHALMOLOGY EAST
Entity type:Organization
Organization Name:ADVANCED OPHTHALMOLOGY EAST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMAKUMAR
Authorized Official - Middle Name:NATARAJAN
Authorized Official - Last Name:GOUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-374-1220
Mailing Address - Street 1:2520 MOSSIDE BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3539
Mailing Address - Country:US
Mailing Address - Phone:412-374-1220
Mailing Address - Fax:412-374-8220
Practice Address - Street 1:2520 MOSSIDE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3539
Practice Address - Country:US
Practice Address - Phone:412-374-1220
Practice Address - Fax:412-374-8220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBINSON EYE CENTER,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-22
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417220174400000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No305S00000XManaged Care OrganizationsPoint of ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001436147OtherHIGHMARK
PA7589430OtherAETNA PPO
PA000000142774OtherUNISON
PA1533333OtherGATEWAY
PA000211356OtherHEALTH AMERICA/HEALTH ASSURANCE
PA312055OtherUPMC
PA7732705OtherCIGNA
PAPA17220OtherVISION BENEFITS OF AMERICA
PA3039591OtherAETNA HMO
PAPA7220OtherEYEMED COLE VISION
PA0019431640001Medicaid
PA065977RBROtherMEDICARE
PA180046091OtherRAILROAD MEDICARE
PA51037OtherDAVIS
PA51037OtherDAVIS
PA7732705OtherCIGNA
PA51037OtherDAVIS