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General NPI Number Information
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NPI Number | 1770472193
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Entity Type | Organization
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Legal Business Name | MEADVILLE OPHTHALMOLOGY CONSULTANTS, PC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 390 LINDEN ST
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City | MEADVILLE
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State | PA
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Zip | 16335-3026
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Country | US
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Telephone | 814-724-5122
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Fax | 814-827-8276
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Provider Business Mailing Address
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Address Line | 1034 GROVE ST
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City | MEADVILLE
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State | PA
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Zip | 16335-2945
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Country | US
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Telephone | 814-724-5122
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Fax | 814-724-8276
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | RENATO SUNTAY
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Credential |
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Telephone | 814-333-5030
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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 |
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