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General NPI Number Information
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NPI Number | 1083640429
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Entity Type | Organization
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Legal Business Name | GRIFASI EYECARE AND OPTICAL, INC.
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 202B SOUTH BRIDGE STR.
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City | ELKTON
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State | MD
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Zip | 21921-5915
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Country | US
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Telephone | 410-392-2323
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Fax | 410-392-2406
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Provider Business Mailing Address
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Address Line | 202B SOUTH BRIDGE STR.
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City | ELKTON
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State | MD
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Zip | 21921-5915
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Country | US
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Telephone | 410-392-2323
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Fax | 410-392-2406
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JUDITH HOLLOWAY GRIFASI
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Credential | O.D.
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Telephone | 410-939-7717
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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 |
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License Number State |
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