Provider Demographics
NPI:1174869895
Name:CRAIG A. SMARGIASSO OD LLC
Entity type:Organization
Organization Name:CRAIG A. SMARGIASSO OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SMARGIASSO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-456-4842
Mailing Address - Street 1:220 S CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8805
Mailing Address - Country:US
Mailing Address - Phone:330-348-0269
Mailing Address - Fax:330-348-0794
Practice Address - Street 1:220 S CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8805
Practice Address - Country:US
Practice Address - Phone:330-348-0269
Practice Address - Fax:330-348-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5897/T2811152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty