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General NPI Number Information
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NPI Number | 1144403098
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Entity Type | Organization
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Legal Business Name | JOANNE BRILLIANT O.D., P.A.
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 1410 FOREST DR SUITE 1
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1442
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Country | US
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Telephone | 410-295-3010
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Fax | 410-295-3015
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Provider Business Mailing Address
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Address Line | 1410 FOREST DR SUITE 1
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1442
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Country | US
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Telephone | 410-295-3010
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Fax | 410-295-3015
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Authorized Official
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Title or Position | DR. OF OPTOMETRY
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Name | DR. JO ANNE BRILLIANT
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Credential | O.D.
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Telephone | 410-295-3010
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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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