MEDICARE: STANCHEL EYE ASSOCIATES, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TA-2082	MD

General Provider Information

NPI Number	:	1730454125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANCHEL EYE ASSOCIATES, L.L.C.

Provider Business Mailing Address
First Line	:	2400 FIVE LEES LANE
Second Line	:	INSIDE COSTCO OPTICAL
City	:	LANHAM
State	:	MD
Zip	:	20706-1617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 FIVE LEES LANE
Second Line	:	INSIDE COSTCO OPTICAL
City	:	LANHAM
State	:	MD
Zip	:	20706-1617
Country	:	US
Telephone Number	:	301-341-6753
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALIZZI J STANCHEL
Credential	:	OD
Telephone Number	:	301-341-6753

Provider Enumeration Date	:	03/19/2012
Last Update Date	:	03/19/2012

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