NPIMap

Organization Active NPI

Aeg Pennsylvania Professional, Inc

Doing business as Eyetique

  • Optometrist
  • Pittsburgh, PA
National Provider Identifier
1699270124
Registry record updated Dec 4, 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
Eyetique -South Hills Vlg.
Practice address
301 S Hills VLG
Pittsburgh, PA 15241
Phone
(412) 854-2222
Fax
(314) 741-4947
NPI assigned
Mar 27, 2018
Last updated
Dec 4, 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 Dec 4, 2023

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

301 S Hills VLG
Pittsburgh, PA 15241

Mailing address

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

Other names 2

  • Eyetique Doing business as
  • Eyetique -South Hills Vlg. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eyetique Corporation10 organizations share this tax ID, including this one
Part of
Aeg Pennsylvania Prof Inc

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1699270124",
    "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": "301 S HILLS VLG",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15241",
            "telephone_number": "412-854-2222",
            "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": "2018-03-27",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "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",
        "authorized_official_credential": "OD FAAO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyetique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eyetique -South Hills Vlg.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.