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General NPI Number Information
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NPI Number | 1073937462
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Entity Type | Organization
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Legal Business Name | LEVIN EYE CARE PARTNERS, LLC
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 106 CHARTLEY DR
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City | REISTERSTOWN
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State | MD
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Zip | 21136-2321
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Country | US
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Telephone | 410-833-6622
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Fax | 410-526-9828
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Provider Business Mailing Address
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Address Line | 4313 EBENEZER RD
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City | NOTTINGHAM
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State | MD
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Zip | 21236-2143
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Country | US
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Telephone | 410-665-1779
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Fax | 410-668-0614
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | AMANDA LEE O'NEIL
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Credential |
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Telephone | 410-665-1779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA1863
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA0654
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License Number State | MD
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