Provider Demographics
NPI:1427380237
Name:DR. DOUGLAS E. GERZINA INC.
Entity type:Organization
Organization Name:DR. DOUGLAS E. GERZINA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GERZINA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-545-3016
Mailing Address - Street 1:290 BECKETT RD
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-3044
Mailing Address - Country:US
Mailing Address - Phone:724-545-3016
Mailing Address - Fax:
Practice Address - Street 1:922 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3100
Practice Address - Country:US
Practice Address - Phone:412-782-3930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET008812152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty