Organization
VISTA OPTOMETRY, LLC
Active
Other names
Wise Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MENELAOS LIULIAS O.D. (OWNER/MANAGING MEMBER)
(724) 612-3711
Entity
Organization
Contact information
Practice address
15 PINE GROVE SQ, GROVE CITY, PA 16127-4447
(724) 458-0333
(724) 458-0335
Mailing address
8131 POST RD, ALLISON PARK, PA 15101-3334
(724) 612-3711
(724) 458-0335
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
5728
OH
152W00000X
Optometrist
Primary
OEG001284
PA
152W00000X
Optometrist
T2642
OH
152WC0802X
Corneal and Contact Management Optometrist
OEG001284
PA
152WX0102X
Occupational Vision Optometrist
OEG001284
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1138132
HEALTH AMERICA
PA
01
—
1982534
HIGHMARK BC/BS
PA
01
—
400553
UPMC HEALTH PLAN
PA
05
—
TBD
—
PA
Enumeration date
09/10/2007
Last updated
02/06/2014
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