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General NPI Number Information
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NPI Number | 1861692733
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Entity Type | Organization
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Legal Business Name | EYECARE ASSOCIATES,INC.
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 2411 W BELVEDERE AVE SINAI MEDICAL OFFICE BUILDING #105
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City | BALTIMORE
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State | MD
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Zip | 21215-5271
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Country | US
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Telephone | 410-601-9991
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Fax | 410-601-9992
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Provider Business Mailing Address
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Address Line | 2411 W BELVEDERE AVE SINAI MEDICAL OFFICE BUILDING #105
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City | BALTIMORE
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State | MD
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Zip | 21215-5271
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Country | US
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Telephone | 410-601-9991
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Fax | 410-601-9992
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MRS. RUTH STATMAN
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Credential | OPTICIAN
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Telephone | 410-601-9991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 3766
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License Number State | NY
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