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General NPI Number Information
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NPI Number | 1043454366
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Entity Type | Organization
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Legal Business Name | EYECARE SOLUTIONS
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 303 1ST ST
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City | CHARLEROI
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State | PA
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Zip | 15022-1427
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Country | US
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Telephone | 724-483-3675
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Fax | 724-483-0404
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Provider Business Mailing Address
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Address Line | 303 1ST ST
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City | CHARLEROI
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State | PA
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Zip | 15022-1427
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Country | US
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Telephone | 724-483-3675
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Fax | 724-483-0404
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN ROBERT MARTINELLI
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Credential | OD
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Telephone | 724-483-3675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG 000671
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License Number State | PA
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