Organization
FAMILY VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MATTHEW CICCHINI O.D. (PARTNER)
(724) 929-7737
Entity
Organization
Contact information
Practice address
527 BROAD AVE, BELLE VERNON, PA 15012-1426
(724) 929-7737
(724) 929-9639
Mailing address
527 BROAD AVE, BELLE VERNON, PA 15012-1426
(724) 929-7737
(724) 929-9639
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG00789
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014992330002
—
PA
01
—
CI075276
BLUE CROSS/SHIELD
PA
01
—
ST130815
BLUE CROSS/SHEILD
PA
Enumeration date
04/26/2006
Last updated
08/22/2020
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