NPIMap

Organization Active NPI

Robert Ottaviani OD

  • Optometrist
  • Wyalusing, PA
National Provider Identifier
1679730071
Registry record updated Oct 23, 2012
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Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000822 Issued in PA
Legal business name
ROBERT OTTAVIANI OD
Practice address
55 Main St
Wyalusing, PA 18853-0307
Phone
(570) 746-1610
Fax
(570) 746-6218
NPI assigned
May 22, 2008
Last updated
Oct 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Mrs. Rosemarie Ottaviani
Title
Office MGR
Phone
(570) 746-1610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OEG000822 PA Primary

Addresses

Primary practice location

55 Main St
Wyalusing, PA 18853-0307

Mailing address

P.O. Box 307
Wyalusing, PA 18853-0307
Phone (570) 746-1610

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1679730071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 307",
            "city": "WYALUSING",
            "state": "PA",
            "postal_code": "188530307",
            "telephone_number": "570-746-1610",
            "fax_number": "570-746-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAIN ST",
            "city": "WYALUSING",
            "state": "PA",
            "postal_code": "188530307",
            "telephone_number": "570-746-1610",
            "fax_number": "570-746-6218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT OTTAVIANI OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "OTTAVIANI",
        "authorized_official_first_name": "ROSEMARIE",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "570-746-1610",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyalusing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.