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General NPI Number Information
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NPI Number | 1407871320
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Entity Type | Organization
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Legal Business Name | VISION MASTERS CORP
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 706 GRAPE STREET
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City | WHITEHALL
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State | PA
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Zip | 18052
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Country | US
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Telephone | 610-266-7700
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Fax | 610-266-9300
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Provider Business Mailing Address
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Address Line | 706 GRAPE STREET
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City | WHITEHALL
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State | PA
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Zip | 18052
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Country | US
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Telephone | 610-266-7700
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Fax | 610-266-9300
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Authorized Official
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Title or Position | OPTOMETRIST OWNER
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Name | DR. DANA MARIE MIGNOGNA
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Credential | OD
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Telephone | 610-266-7700
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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 | OE 007828 T
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License Number State | PA
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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 | OE007800T
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001256
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License Number State | PA
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