Provider Demographics
NPI:1568616415
Name:TRI STATE LASIK AND CATARACT CENTERS LLC
Entity Type:Organization
Organization Name:TRI STATE LASIK AND CATARACT CENTERS LLC
Other - Org Name:SPARTAN EYE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-483-9290
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-0117
Mailing Address - Country:US
Mailing Address - Phone:724-483-9290
Mailing Address - Fax:724-483-0404
Practice Address - Street 1:100 STOOPS DR
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-3553
Practice Address - Country:US
Practice Address - Phone:724-483-9290
Practice Address - Fax:724-483-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty