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General NPI Number Information
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NPI Number | 1427126267
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Entity Type | Organization
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Legal Business Name | VISIONCARE LASER CENTERS OF ERIE
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1909 WEST 8TH STREET
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City | ERIE
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State | PA
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Zip | 16505-4936
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Country | US
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Telephone | 814-454-7088
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Fax | 814-459-5189
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Provider Business Mailing Address
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Address Line | 1909 WEST 8TH STREET
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City | ERIE
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State | PA
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Zip | 16505-4936
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Country | US
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Telephone | 814-454-7088
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Fax | 814-459-5189
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. JAMES THOMAS CANELLA
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Credential |
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Telephone | 814-454-7088
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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 | OB007924A
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License Number State | PA
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