# BERKSHIRE EYE SURGERY CENTER LP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154325686
- **Authorized official:** DR. DOMENIC C IZZO JR. M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (610) 736-0144

## Contact information

- **Practice address:** 2220 RIDGEWOOD RD, WYOMISSING, PA 19610-1167
- **Practice address phone:** (610) 736-0144
- **Practice address fax:** (610) 736-0926
- **Mailing address:** 2220 RIDGEWOOD RD, WYOMISSING, PA 19610-1167
- **Mailing address phone:** (610) 736-0144
- **Mailing address fax:** (610) 736-0926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 15291501 | PA | Yes |

## Other

- **Enumeration date:** 06/13/2005
- **Last updated:** 11/20/2009