Provider Demographics
NPI:1275761967
Name:THE EYESIGHT CENTER
Entity Type:Organization
Organization Name:THE EYESIGHT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-483-8065
Mailing Address - Street 1:PO BOX 212
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022
Mailing Address - Country:US
Mailing Address - Phone:724-483-8065
Mailing Address - Fax:724-565-5110
Practice Address - Street 1:305 MCKEAN AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022
Practice Address - Country:US
Practice Address - Phone:724-483-8065
Practice Address - Fax:724-565-5110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA020526E207W00000X
PAMD-020526-E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023740670001Medicaid
PA1023740670001Medicaid
PA0715200001Medicare NSC
PAC30472Medicare UPIN