Organization
KEYSTONE RETINA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADFORD SGRIGNOLI DO (FOUNDER/PRESIDENT)
(717) 319-0546
Entity
Organization
Contact information
Practice address
850 WALNUT BOTTOM RD STE 105, CARLISLE, PA 17013-3615
(717) 319-0546
Mailing address
212 ANNIKA WAY, MECHANICSBURG, PA 17050-4156
(717) 319-0546
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS017847
PENNSYLVANIA MEDICAL LICENSE NUMBER
PA
Enumeration date
12/09/2024
Last updated
12/09/2024
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