Provider Demographics
NPI:1871719112
Name:CHRISTY, LAURA STEINER (OD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:STEINER
Last Name:CHRISTY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3228
Mailing Address - Country:US
Mailing Address - Phone:304-599-1814
Mailing Address - Fax:
Practice Address - Street 1:2356 MEADOWBROOK MALL
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-9790
Practice Address - Country:US
Practice Address - Phone:304-842-7335
Practice Address - Fax:304-842-7337
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV887-D152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVU06430Medicare UPIN
WVST717900Medicare ID - Type Unspecified