Provider Demographics
NPI:1821116005
Name:LANCASTER CONTACT LENS INC
Entity Type:Organization
Organization Name:LANCASTER CONTACT LENS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIVIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-569-7386
Mailing Address - Street 1:700 EDEN RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4712
Mailing Address - Country:US
Mailing Address - Phone:717-569-7386
Mailing Address - Fax:717-560-7531
Practice Address - Street 1:700 EDEN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4712
Practice Address - Country:US
Practice Address - Phone:717-569-7386
Practice Address - Fax:717-560-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000298152W00000X
156FC0801X, 156FX1700X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens FitterGroup - Multi-Specialty
Not Answered156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Multi-Specialty
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0507160001Medicare NSC