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General NPI Number Information
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NPI Number | 1639392509
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Entity Type | Organization
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Legal Business Name | DR. JIL KLEIN - DELMARVA VISION ASSOC'S, P.C.
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 1504 S SALISBURY BLVD SUITE #20
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City | SALISBURY
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State | MD
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Zip | 21801-7165
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Country | US
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Telephone | 410-334-3900
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Fax | 410-334-3955
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Provider Business Mailing Address
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Address Line | 1504 S SALISBURY BLVD SUITE #20
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City | SALISBURY
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State | MD
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Zip | 21801-7165
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Country | US
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Telephone | 410-334-3900
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Fax | 410-334-3955
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JIL KLEIN
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Credential | O.D.
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Telephone | 410-334-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | TA1384
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License Number State | MD
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