Healthcare Provider Details

I. General information

NPI: 1063415511
Provider Name (Legal Business Name): STANLEY KAPLAN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2005
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5415 CONNECTICUT AVE NW
WASHINGTON DC
20015-2765
US

IV. Provider business mailing address

5415 CONNECTICUT AVE NW
WASHINGTON DC
20015-2765
US

V. Phone/Fax

Practice location:
  • Phone: 202-686-0200
  • Fax: 202-966-3327
Mailing address:
  • Phone: 202-686-0200
  • Fax: 202-966-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOP415
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: