Provider Demographics
NPI:1992896682
Name:BLIND AND VISION REHABILITATION SERVICES OF PITTSBURGH
Entity type:Organization
Organization Name:BLIND AND VISION REHABILITATION SERVICES OF PITTSBURGH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-368-4400
Mailing Address - Street 1:1816 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5920
Mailing Address - Country:US
Mailing Address - Phone:412-368-4400
Mailing Address - Fax:412-368-4090
Practice Address - Street 1:1816 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5920
Practice Address - Country:US
Practice Address - Phone:412-368-4400
Practice Address - Fax:412-368-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA005806Medicare ID - Type UnspecifiedPROVIDER NUMBER