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General NPI Number Information
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NPI Number | 1952540676
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Entity Type | Organization
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Legal Business Name | JEFFREY P. MAINOLFI,O.D.,INC.
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 1000 E PULASKI HWY VISION CENTER
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City | ELKTON
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State | MD
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Zip | 21921-6306
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Country | US
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Telephone | 410-620-5251
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Fax | 410-620-5307
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Provider Business Mailing Address
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Address Line | 1000 E PULASKI HWY VISION CENTER
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City | ELKTON
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State | MD
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Zip | 21921-6306
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Country | US
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Telephone | 410-620-5251
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Fax | 410-620-5307
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JEFFREY P MAINOLFI
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Credential | OD
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Telephone | 410-937-1124
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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 | TA 1370
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License Number State | MD
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