Provider Demographics
NPI:1699743765
Name:SOUTH HILLS EYE ASSOCIATES
Entity type:Organization
Organization Name:SOUTH HILLS EYE ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:B
Authorized Official - Last Name:NABEREZNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-561-1964
Mailing Address - Street 1:713 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2001
Mailing Address - Country:US
Mailing Address - Phone:412-561-1964
Mailing Address - Fax:412-561-7295
Practice Address - Street 1:713 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-2001
Practice Address - Country:US
Practice Address - Phone:412-561-1964
Practice Address - Fax:412-561-7295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA180039524OtherRAILROAD MEDICARE
PAP00007407OtherRAILROAD MEDICARE
PA180009538OtherRAILROAD MEDICARE
PA180024366OtherRAILROAD MEDICARE
PA180009539OtherRAILROAD MEDICARE
PA180015304OtherRAILROAD MEDICARE
PA180039523OtherRAILROAD MEDICARE
PA180015304OtherRAILROAD MEDICARE
PAH81693Medicare UPIN
PAC29924Medicare UPIN
PAP00007407OtherRAILROAD MEDICARE
PA180039524OtherRAILROAD MEDICARE