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PENN OPTICAL CO LTD

Eye and Vision Services Providers Optometrist Corneal and Contact Management

Provider NPI: 1235325432

Organization Information:
Organization Name:  PENN OPTICAL CO LTD
Organization is not Subpart
Authorized Official:  RICHARD  FUSS  PRESIDENT  410-488-6800

Practice Location:
2483 FREDERICK AVE  BALTIMORE, MD 21223-2856 US
Tel: 410-233-8222  Fax: 410-947-4360

Business Mailing Address:
5006 SINCLAIR LN  BALTIMORE, MD 21206-5936 US
Tel: 410-488-6800  Fax: 410-488-4270

NPI Information:
NPI: 1235325432
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N152WC0802XEye and Vision Services Providers
Optometrist
Corneal and Contact Management
N152WP0200XEye and Vision Services Providers
Optometrist
N152WS0006XEye and Vision Services Providers
Optometrist
N152WX0102XEye and Vision Services Providers
Optometrist
Y152W00000XEye and Vision Services Providers
Optometrist

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 152W00000X

Type:

Classification:



Definition:



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