Provider Demographics
NPI:1003251109
Name:MEDICAL EYE ASSOCIATES OF BALTIMORE PC
Entity Type:Organization
Organization Name:MEDICAL EYE ASSOCIATES OF BALTIMORE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-336-6634
Mailing Address - Street 1:7840 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4301
Mailing Address - Country:US
Mailing Address - Phone:513-354-5808
Mailing Address - Fax:513-354-5774
Practice Address - Street 1:22 WEST RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2326
Practice Address - Country:US
Practice Address - Phone:410-337-4921
Practice Address - Fax:410-828-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052124207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty