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General NPI Number Information
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NPI Number | 1548364045
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Entity Type | Organization
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Legal Business Name | ASSOCIATED EYE CARE OPTOMETRY PA
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 2227 OLD EMMORTON RD STE 114
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City | BEL AIR
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State | MD
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Zip | 21015-6187
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Country | US
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Telephone | 410-569-7173
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Fax | 410-569-7123
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Provider Business Mailing Address
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Address Line | 2227 OLD EMMORTON RD STE 114
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City | BEL AIR
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State | MD
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Zip | 21015-6190
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Country | US
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Telephone | 410-569-7173
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Fax | 410-569-7123
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES EDWARD LOSKOT
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Credential | OD
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Telephone | 410-569-7173
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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 | MD 1466
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License Number State | MD
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