Healthcare Provider Details

I. General information

NPI: 1891773719
Provider Name (Legal Business Name): JAY NEIL PARRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 10/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 BELAIR RD SUITE 1A
BALTIMORE MD
21206-1855
US

IV. Provider business mailing address

6600 BELAIR RD SUITE 1A
BALTIMORE MD
21206-1855
US

V. Phone/Fax

Practice location:
  • Phone: 410-254-2025
  • Fax: 410-254-2011
Mailing address:
  • Phone: 410-254-2025
  • Fax: 410-254-2011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD12644
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0012644
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: