Provider Demographics
NPI:1538175914
Name:PRECISION VISION CENTER INC.
Entity type:Organization
Organization Name:PRECISION VISION CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHESSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-838-8883
Mailing Address - Street 1:3279 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2537
Mailing Address - Country:US
Mailing Address - Phone:814-838-8883
Mailing Address - Fax:814-838-8497
Practice Address - Street 1:2049 INTERCHANGE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-8315
Practice Address - Country:US
Practice Address - Phone:814-838-8883
Practice Address - Fax:814-838-8497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE006713P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPR065847OtherBLUE CROSS BLUE SHIELD
PA396117OtherNATIONAL VISION ASSOCIATE
PA0012858540003Medicaid
PA396117OtherNATIONAL VISION ASSOCIATE
PACH437643Medicare UPIN
PA046238Medicare ID - Type Unspecified