Organization
BERKSHIRE EYE SURGERY CENTER LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMENIC C IZZO JR. M.D. (MEDICAL DIRECTOR)
(610) 736-0144
Entity
Organization
Contact information
Practice address
2220 RIDGEWOOD RD, WYOMISSING, PA 19610-1167
(610) 736-0144
(610) 736-0926
Mailing address
2220 RIDGEWOOD RD, WYOMISSING, PA 19610-1167
(610) 736-0144
(610) 736-0926
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
15291501
PA
Other
Enumeration date
06/13/2005
Last updated
11/20/2009
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