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General NPI Number Information
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NPI Number | 1962046458
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Entity Type | Organization
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Legal Business Name | VISION INNOVATION CENTERS OF PENNSYLVANIA LLC
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 703 RUTTER AVE
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City | KINGSTON
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State | PA
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Zip | 18704-4801
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Country | US
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Telephone | 410-571-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 703 RUTTER AVE
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City | KINGSTON
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State | PA
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Zip | 18704-4801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL PASCETTA
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Credential |
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Telephone | 860-652-5002
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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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