Individual
JONATHAN E ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
500 LEWIS RUN RD, SUITE 218, WEST MIFFLIN, PA 15122-3056
(412) 466-9582
(412) 466-7906
Mailing address
500 LEWIS RUN RD, SUITE 218, WEST MIFFLIN, PA 15122-3056
(412) 466-9582
(412) 466-7906
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001711
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101541859
MEDICAID PROVIDER #
PA
01
—
1054419
AETNA HMO
PA
01
—
251100359004
CAHMPVA/ TRICARE
PA
01
—
266195
ADVANTRA
PA
01
—
410781
UPMC
PA
01
—
7128770
AETNA COMMERCIAL
PA
01
—
CIGNA
9872744
PA
Enumeration date
10/31/2005
Last updated
09/15/2008
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