Provider Demographics
NPI:1902879844
Name:CROSSROADS EYE CARE ASSOCIATES, LTD
Entity Type:Organization
Organization Name:CROSSROADS EYE CARE ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:D'ORAZIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:724-941-1466
Mailing Address - Street 1:4160 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2533
Mailing Address - Country:US
Mailing Address - Phone:724-941-1466
Mailing Address - Fax:724-941-6310
Practice Address - Street 1:4160 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2533
Practice Address - Country:US
Practice Address - Phone:724-941-1466
Practice Address - Fax:724-941-6310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001834446Medicaid
102471OtherUPMC
PA141069OtherHIGHMARK BC/BS
PA781493Medicare PIN
PA141069OtherHIGHMARK BC/BS
PA4094280001Medicare NSC