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NPI Code Detail

MEDICARE: GRIFASI EYECARE AND OPTICAL, INC.

MEDICARE: GRIFASI EYECARE AND OPTICAL, INC.
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1083640429
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRIFASI EYECARE AND OPTICAL, INC.
Provider Business Mailing Address
First Line : 202B SOUTH BRIDGE STR.
Second Line :
City : ELKTON
State : MD
Zip : 21921-5915
Country : US
Telephone Number : 410-392-2323
Fax Number : 410-392-2406
Provider Business Practice Location Address
First Line : 202B SOUTH BRIDGE STR.
Second Line :
City : ELKTON
State : MD
Zip : 21921-5915
Country : US
Telephone Number : 410-392-2323
Fax Number : 410-392-2406
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : DR. JUDITH HOLLOWAY GRIFASI
Credential : O.D.
Telephone Number : 410-939-7717
Provider Enumeration Date : 06/25/2006
Last Update Date : 03/18/2009

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Directions to “GRIFASI EYECARE AND OPTICAL, INC. ” Practice Location

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