Provider Demographics
NPI:1952505695
Name:BERKS EYE PHYSICIANS & SURGEONS, LTD
Entity Type:Organization
Organization Name:BERKS EYE PHYSICIANS & SURGEONS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMENIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:IZZO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:610-372-0712
Mailing Address - Street 1:1802 PAPERMILL RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1100
Mailing Address - Country:US
Mailing Address - Phone:610-372-0712
Mailing Address - Fax:610-376-6968
Practice Address - Street 1:1802 PAPERMILL RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1100
Practice Address - Country:US
Practice Address - Phone:610-372-0712
Practice Address - Fax:610-376-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0374260001OtherNHIC-DME
PA0374260001OtherNHIC-DME