Provider Demographics
NPI:1770721565
Name:THE CENTER FOR SIGHT, PLLC
Entity type:Organization
Organization Name:THE CENTER FOR SIGHT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCALISEGORDY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:336-744-5550
Mailing Address - Street 1:4964 UNIVERSITY PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-2800
Mailing Address - Country:US
Mailing Address - Phone:336-744-5550
Mailing Address - Fax:336-744-5554
Practice Address - Street 1:4964 UNIVERSITY PKWY STE 105
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-2800
Practice Address - Country:US
Practice Address - Phone:336-744-5550
Practice Address - Fax:336-744-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33196207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2401146Medicaid