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General NPI Number Information
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NPI Number | 1629374574
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Entity Type | Organization
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Legal Business Name | DRS. VAXMONSKY & BALOGA EYE CARE
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Dates
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Enumeration Date | 02/09/2011
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 3500 E WEST HWY C/O LENSCRAFTERS
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City | HYATTSVILLE
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State | MD
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Zip | 20782-1916
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Country | US
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Telephone | 301-559-0090
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Fax | 301-559-1964
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Provider Business Mailing Address
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Address Line | 3500 E WEST HWY C/O LENSCRAFTERS
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City | HYATTSVILLE
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State | MD
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Zip | 20782-1916
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Country | US
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Telephone | 301-559-0090
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Fax | 301-559-1964
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS J VAXMONSKY
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Credential | O.D.
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Telephone | 301-559-0090
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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 | MDTA0999
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License Number State | MD
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