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General NPI Number Information
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NPI Number | 1871025213
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Entity Type | Organization
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Legal Business Name | OPHTHALMIC ASSOCIATES
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/04/2017
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Provider Practice Location Address
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Address Line | 215 GEORGIAN PL
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City | SOMERSET
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State | PA
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Zip | 15501-1610
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Country | US
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Telephone | 814-445-3730
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Fax | 814-445-5496
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Provider Business Mailing Address
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Address Line | 120 MAIN ST
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City | JOHNSTOWN
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State | PA
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Zip | 15901-1507
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Country | US
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Telephone | 814-536-5343
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Fax |
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Authorized Official
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Title or Position | OPHTHALMOLOGIST/PRESIDENT
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Name | DR. JOSEPH R POLITO
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Credential | M.D.
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Telephone | 814-536-5343
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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 |
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License Number State |
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