Provider Demographics
NPI:1215040456
Name:DRS. KASPER AND LOEB, P.A.
Entity Type:Organization
Organization Name:DRS. KASPER AND LOEB, P.A.
Other - Org Name:THE OPTICAL PLACE
Other - Org Type:Other Name
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-282-6245
Mailing Address - Street 1:1105 N POINT BLVD
Mailing Address - Street 2:SUITE 324
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3419
Mailing Address - Country:US
Mailing Address - Phone:410-282-6245
Mailing Address - Fax:
Practice Address - Street 1:1105 N POINT BLVD
Practice Address - Street 2:SUITE 324
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3419
Practice Address - Country:US
Practice Address - Phone:410-282-6245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03180675332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0839880002Medicare NSC