Organization
EYE SURGERY OF THE MAIN LINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANITA NEVYAS-WALLACE MD (MEMBER)
(610) 668-2847
Entity
Organization
Contact information
Practice address
333 E CITY AVENUE, TWO BALA PLAZA, BALA CYNWYD, PA 19004-1501
(610) 668-2777
Mailing address
333 E CITY AVE, TWO BALA PLAZA, BALA CYNWYD, PA 19004-1501
(610) 668-2847
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2020
Last updated
09/25/2025
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