NPIMap

Organization Active NPI

Aeg Pennsylvania Professional, Inc

Doing business as Eyetique -Sewickley

  • Optometrist
  • Sewickley, PA
National Provider Identifier
1104238088
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AEG PENNSYLVANIA PROFESSIONAL, INC
Doing business as
Eyetique -Sewickley
Practice address
411 Beaver St
Sewickley, PA 15143
Phone
(412) 422-5300
Fax
(314) 741-4947
NPI assigned
May 27, 2014
Last updated
Nov 14, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AEG PENNSYLVANIA PROFESSIONAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Benjamin Chudner
Title
Owner
Phone
(618) 462-9818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

411 Beaver St
Sewickley, PA 15143

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818

Other names 1

  • Eyetique -Sewickley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aeg Pennsylvania Prof Inc29 organizations share this tax ID, including this one
Part of
Aeg Pennsylvania Prof Inc

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

1597 Washington Pike
Ste A4
Bridgeville, PA 15017
Phone (412) 668-3709

3001 Waterdam Plaza Dr
Ste 120
McMurray, PA 15317
Phone (724) 260-0243

2460 Robinson Center Dr
Pittsburgh, PA 15205
Phone (412) 788-5353

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1104238088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BEAVER ST",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "15143",
            "telephone_number": "412-422-5300",
            "fax_number": "314-741-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AEG PENNSYLVANIA PROFESSIONAL, INC",
        "enumeration_date": "2014-05-27",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "CHUDNER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyetique -Sewickley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sewickley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.