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General NPI Number Information
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NPI Number | 1144310418
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Entity Type | Individual
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Provider Name | MARY ELLEN PADUSI O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 4134 E JOPPA RD SUITE 101
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City | NOTTINGHAM
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State | MD
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Zip | 21236-2284
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Country | US
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Telephone | 410-256-1006
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Fax | 410-256-0088
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Provider Business Mailing Address
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Address Line | 110 BEACON POINT CT
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City | JOPPA
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State | MD
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Zip | 21085-4533
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Country | US
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Telephone | 410-679-5922
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TA0922
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | TA0922
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License Number State | MD
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