Healthcare Provider Details

I. General information

NPI: 1275761967
Provider Name (Legal Business Name): THE EYESIGHT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 02/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 MCKEAN AVENUE
CHARLEROI PA
15022
US

IV. Provider business mailing address

PO BOX 212
CHARLEROI PA
15022
US

V. Phone/Fax

Practice location:
  • Phone: 724-483-8065
  • Fax: 724-565-5110
Mailing address:
  • Phone: 724-483-8065
  • Fax: 724-565-5110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number020526E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD-020526-E
License Number StatePA

VIII. Authorized Official

Name: KATHLEEN CASTNER
Title or Position: OFFICE MANAGER
Credential:
Phone: 724-483-8065