Organization
EYETIQUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY L SHORT (CREDENTIALING MANAGER)
(618) 462-9818
Entity
Organization
Contact information
Practice address
208 5TH AVE, PITTSBURGH, PA 15222
(412) 281-9199
(412) 281-9210
Mailing address
208 5TH AVE, PITTSBURGH, PA 15222-2701
(412) 281-9199
(412) 281-9210
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE006128P
PA
332H00000X
Eyewear Supplier
6000002687
PA
Other
Enumeration date
03/03/2009
Last updated
07/15/2020
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