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General NPI Number Information
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NPI Number | 1013721562
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Entity Type | Organization
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Legal Business Name | SHORE REGIONAL EYE CARE, LLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 9956 N MAIN ST UNIT 4
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City | BERLIN
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State | MD
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Zip | 21811-1077
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Country | US
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Telephone | 609-828-2651
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Fax | 443-228-6040
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Provider Business Mailing Address
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Address Line | 9956 N MAIN ST UNIT 4
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City | BERLIN
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State | MD
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Zip | 21811-1077
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Country | US
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Telephone | 443-242-4070
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Fax | 443-200-0234
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. LISA MARIE CLIFFORD
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Credential | MBA, DPT
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Telephone | 443-242-4070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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