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NPI Code Detail

MEDICARE: SHALANE PERLOWSKY OD PC

MEDICARE: SHALANE PERLOWSKY OD PC
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 : 1154673622
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHALANE PERLOWSKY OD PC
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 : OPTOMETRIST
Name : DR. SHALANE PERLOWSKY
Credential : O.D.
Telephone Number : 757-463-1508
Provider Enumeration Date : 10/09/2012
Last Update Date : 10/16/2012

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