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General NPI Number Information
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NPI Number | 1962795328
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Entity Type | Organization
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Legal Business Name | UNIQUE OPTIQUE, PC
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 9 W PATRICK ST
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City | FREDERICK
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State | MD
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Zip | 21701-5511
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Country | US
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Telephone | 301-620-8595
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Fax | 301-620-8590
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Provider Business Mailing Address
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Address Line | 9 W PATRICK ST
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City | FREDERICK
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State | MD
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Zip | 21701-5511
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Country | US
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Telephone | 301-620-8595
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Fax | 301-620-8590
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA HIGGINS
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Credential | O.D.
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Telephone | 301-620-8595
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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 2179
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License Number State | MD
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