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NPI Code Detail

MEDICARE: SHALANE BREE PERLOWSKY O.D.

MEDICARE: SHALANE BREE PERLOWSKY O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist0618002184VA

General Provider Information

NPI Number : 1073862108
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALANE BREE PERLOWSKY O.D.
Provider Business Mailing Address
First Line : 3345 VIRGINIA BEACH BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-5616
Country : US
Telephone Number : 757-463-1508
Fax Number : 757-463-1864
Provider Business Practice Location Address
First Line : 3345 VIRGINIA BEACH BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23452-5616
Country : US
Telephone Number : 757-463-1508
Fax Number : 757-463-1864
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2012
Last Update Date : 10/09/2012

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Directions to “ SHALANE BREE PERLOWSKY O.D.” Practice Location

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