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General NPI Number Information
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NPI Number | 1336024025
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Entity Type | Organization
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Legal Business Name | OPHTHALMOLOGY ASSOCIATES S C
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 14300 WEST NATIONAL AVE SUITE 200
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City | NEW BERLIN
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State | WI
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Zip | 53151
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Country | US
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Telephone | 262-784-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 W LOOMIS RD STE 310
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City | GREENFIELD
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State | WI
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Zip | 53220-4858
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Country | US
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Telephone | 414-281-0424
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | TONI BERTINO
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Credential |
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Telephone | 414-294-4660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207WX0120X
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Taxonomy Name | Cornea and External Diseases Specialist Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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