Healthcare Provider Details

I. General information

NPI: 1184500621
Provider Name (Legal Business Name): PREVENTION OF BLINDNESS SOCIETY OF METROPOLITAN WASHINGTON INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4948 SAINT ELMO AVE STE 209
BETHESDA MD
20814-6066
US

IV. Provider business mailing address

415 2ND ST NE STE 200
WASHINGTON DC
20002-4900
US

V. Phone/Fax

Practice location:
  • Phone: 202-234-1010
  • Fax:
Mailing address:
  • Phone: 202-234-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State

VIII. Authorized Official

Name: NICK FARANO
Title or Position: VICE PRESIDENT
Credential:
Phone: 202-234-1010