| NPI | 1902074875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT JOSEPH KLONSKY Owner 410-721-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MD TAO687) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MD TAO687) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-04-04 |