Healthcare Provider Details
I. General information
NPI: 1811608078
Provider Name (Legal Business Name): VISION INNOVATION CENTERS OF PENNSYLVANIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2022
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 PENN AVE
WEST READING PA
19611-1262
US
IV. Provider business mailing address
301 PENN AVE
WEST READING PA
19611-1262
US
V. Phone/Fax
- Phone: 610-372-2222
- Fax:
- Phone: 610-372-2222
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 156FX1800X |
| Taxonomy | Optician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
PASCETTA
Title or Position: CFO
Credential:
Phone: 860-652-5002