Organization
BERKS EYE PHYSICIANS & SURGEONS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMENIC C IZZO JR. M.D. (PRESIDENT)
(610) 372-0712
Entity
Organization
Contact information
Practice address
1802 PAPERMILL RD, WYOMISSING, PA 19610-1100
(610) 372-0712
(610) 376-6968
Mailing address
1802 PAPERMILL RD, WYOMISSING, PA 19610-1100
(610) 372-0712
(610) 376-6968
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019737000
KEYSTONE HEALTH PLAN EAST
PA
01
—
03187200
CAPITAL BLUE CROSS
PA
01
—
0374260001
DMERC
PA
01
—
039403
HIGHMARK BLUE SHIELD
PA
01
—
073646
BLUE SHIELD
PA
05
—
1007703650007
—
PA
01
—
17367
AETNA
PA
01
—
4559911
AETNA
PA
Enumeration date
03/31/2006
Last updated
03/14/2016
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