Provider Demographics
NPI:1144401530
Name:HALPERN EYE CARE OF MARYLAND, INC.
Entity Type:Organization
Organization Name:HALPERN EYE CARE OF MARYLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:HALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:302-346-1520
Mailing Address - Street 1:920 REVOLUTION ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3748
Mailing Address - Country:US
Mailing Address - Phone:410-939-2200
Mailing Address - Fax:410-939-5980
Practice Address - Street 1:5 BEL AIR SOUTH PKWY
Practice Address - Street 2:SUITE 117
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6091
Practice Address - Country:US
Practice Address - Phone:410-569-0500
Practice Address - Fax:410-569-0502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HALPERN EYE CARE OF MARYLAND, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-14
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0320300001Medicare NSC