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Organization

BEN DOMIANO OPTICAL INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN G DOMIANO ABOC OPTICIAN (PRESIDENT)
(570) 457-2020
Entity
Organization

Contact information

Practice address
817 S MAIN ST, OLD FORGE, PA 18518-1431
(570) 457-2020
(570) 457-2787
Mailing address
817 S MAIN ST, OLD FORGE, PA 18518-1431
(570) 457-2020
(570) 457-2787

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15932
SPECTARA
MD
01
393342
NVA
NJ
01
48926
GEISINGER
PA
01
9911
DAVIS VISION
NY
01
BE282600
CLARITY VISION
PA
01
DO0001565000
HIGHMARK
PA
01
PA0685
EYEMED/COLE VISION
OH
01
PA817
VISION BENEFITS OF AMERIC
PA
Enumeration date
05/26/2006
Last updated
08/17/2018
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