# BEN DOMIANO OPTICAL INCORPORATED

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

## Provider details

- **NPI number:** 1639125214
- **Authorized official:** BENJAMIN G DOMIANO ABOC OPTICIAN (PRESIDENT)
- **Authorized official phone:** (570) 457-2020

## Contact information

- **Practice address:** 817 S MAIN ST, OLD FORGE, PA 18518-1431
- **Practice address phone:** (570) 457-2020
- **Practice address fax:** (570) 457-2787
- **Mailing address:** 817 S MAIN ST, OLD FORGE, PA 18518-1431
- **Mailing address phone:** (570) 457-2020
- **Mailing address fax:** (570) 457-2787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | — | PA | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 08/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 15932 | SPECTARA | MD |
| 01 | — | 393342 | NVA | NJ |
| 01 | — | 48926 | GEISINGER | PA |
| 01 | — | 9911 | DAVIS VISION | NY |
| 01 | — | BE282600 | CLARITY VISION | PA |
| 01 | — | DO0001565000 | HIGHMARK | PA |
| 01 | — | PA0685 | EYEMED/COLE VISION | OH |
| 01 | — | PA817 | VISION BENEFITS OF AMERIC | PA |