Healthcare Provider Details

I. General information

NPI: 1235117441
Provider Name (Legal Business Name): PARRIS CASTORO EYE CARE CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 BOULTON ST
BEL AIR MD
21014-4255
US

IV. Provider business mailing address

620 BOULTON ST
BEL AIR MD
21014-4255
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-0480
  • Fax: 410-893-9796
Mailing address:
  • Phone: 410-893-0480
  • Fax: 410-893-9796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY JO O'CONNEL
Title or Position: BUSINESS MANAGER
Credential:
Phone: 410-399-8451