NPI:
1609848472
Provider Name:
PENNSYLVANIA EYE & EAR SURGERY
Other Name: PA EYE & EAR SURGERY CENTER, LLC
Classification:
Clinic/Center - 261QA1903X
Entity Type:
Organization
Specialization: Ambulatory Surgical
CLIA Number: 39D1010108
Address:
1 GRANITE POINT DR
SUITE 200
WYOMISSING, PA
ZIP 19610
Phone:
(610) 685-9204
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PENNSYLVANIA EYE & EAR SURGERY is an ambulatory surgical clinic center in Wyomissing, PA. PENNSYLVANIA EYE & EAR SURGERY NPI is 1609848472. The provider is registered as an organization entity type.
The provider Other Name Is Pa Eye & Ear Surgery Center, Llc.
The provider's business location address is:
1 GRANITE POINT DR
SUITE 200
WYOMISSING, PA
ZIP 19610-986
Phone: (610) 685-9204
Fax: (610) 685-5308
The provider's authorized official is David L O'donnell .
The authorized official title is Administrator and has the following contact phone number (610) 378-1348.
The CLIA number assigned to this NPI record is 39D1010108 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/6/2006 and was last updated on 6/19/2008.