Provider Demographics
NPI:1811958655
Name:FELDSTEIN, RICHARD A (OD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:FELDSTEIN
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 1:13 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4511
Mailing Address - Country:US
Mailing Address - Phone:724-225-4410
Mailing Address - Fax:724-225-4414
Practice Address - Street 1:13 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4511
Practice Address - Country:US
Practice Address - Phone:724-225-4410
Practice Address - Fax:724-225-4414
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE004175P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005470500001Medicaid
PA288037Medicare PIN
PAU08034Medicare UPIN
PA0154180001Medicare NSC
PA410004855Medicare PIN