Domiano Eye Care Center | |
189 North Main Street, Old Forge, PA 18518-1755 | |
(570) 451-2020 | |
(570) 451-3083 |
Full Name | Domiano Eye Care Center |
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Type | Facility |
Speciality | Optometrist |
Location | 189 North Main Street, Old Forge, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659531721 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OEG000869 (Pennsylvania) | Primary |
152W00000X | Optometrist | MD0417368 (Pennsylvania) | Secondary |
152W00000X | Optometrist | OE007704T (Pennsylvania) | Secondary |
Provider Name | Michele L Domiano |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1265406730 PECOS PAC ID: 2961579982 Enrollment ID: I20081114000539 |
Mailing Address | Practice Location Address |
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Domiano Eye Care Center 189 North Main Street, Old Forge, PA 18518-1755 Ph: (570) 451-2020 | Domiano Eye Care Center 189 North Main Street, Old Forge, PA 18518-1755 Ph: (570) 451-2020 |
Dr. Michele L Domiano, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 189 N Main St, Old Forge, PA 18518 Phone: 570-451-2020 Fax: 570-451-3083 | |
Ben Domiano Optical Center Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 817 S Main St, Old Forge, PA 18518 Phone: 570-457-2020 Fax: 570-457-2787 |