Organization
MAIN STREET ASC LLC
Active
Other names
Ophthalmic Associates Surgery and Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH R POLITO MD (PRESIDENT GOVERNING BODY)
(814) 266-5795
Entity
Organization
Contact information
Practice address
1318 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 536-5343
(814) 536-1525
Mailing address
1318 EISENHOWER BOULEVARD, JOHNSTOWN, PA 15904-3307
(814) 266-5795
(814) 266-5793
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
APPLIED
PA
Other
Enumeration date
05/17/2006
Last updated
04/15/2011
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