Provider Demographics
NPI:1629218532
Name:SOLOMON C. LUO, MD, PC
Entity Type:Organization
Organization Name:SOLOMON C. LUO, MD, PC
Other - Org Name:PROGRESSIVE VISION INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:C
Authorized Official - Last Name:LUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-628-4444
Mailing Address - Street 1:201 E LAUREL BLVD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2534
Mailing Address - Country:US
Mailing Address - Phone:570-628-4444
Mailing Address - Fax:570-628-3088
Practice Address - Street 1:1300 BROADCASTING RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3220
Practice Address - Country:US
Practice Address - Phone:610-396-9999
Practice Address - Fax:610-396-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0547750003Medicare NSC