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General NPI Number Information
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NPI Number | 1386785210
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Entity Type | Organization
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Legal Business Name | ERIE EYE CLINIC, INC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 128 W 12TH ST STE 200
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City | ERIE
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State | PA
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Zip | 16501-1750
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Country | US
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Telephone | 814-452-2796
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Fax | 814-454-7484
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Provider Business Mailing Address
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Address Line | 128 W 12TH ST STE 200
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City | ERIE
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State | PA
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Zip | 16501-1750
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Country | US
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Telephone | 814-452-2796
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Fax | 814-454-7484
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY D SALA II
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Credential | D.O.
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Telephone | 814-452-2796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | PA
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