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General NPI Number Information
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NPI Number | 1518087543
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Entity Type | Organization
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Legal Business Name | VISION CENTER OPTICIAN
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Dates
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Enumeration Date | 03/31/2007
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 12015 E ROCKVILLE PIKE
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City | ROCKVILLE
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State | MD
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Zip | 20852
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Country | US
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Telephone | 301-770-7084
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Fax | 301-770-7085
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Provider Business Mailing Address
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Address Line | 12015 E ROCKVILLE PIKE
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City | ROCKVILLE
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State | MD
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Zip | 20852
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Country | US
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Telephone | 301-770-7084
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Fax | 301-770-7085
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Authorized Official
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Title or Position | OPTICIAN OWNER
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Name | MR. ROBERT BOJARSKI
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Credential | DO
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Telephone | 301-871-6454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1101 003357
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License Number State | VA
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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 | DA0890
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License Number State | MD
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