Provider Demographics
NPI:1235117441
Name:PARRIS CASTORO EYE CARE CENTER, P.A.
Entity Type:Organization
Organization Name:PARRIS CASTORO EYE CARE CENTER, P.A.
Other - Org Name:PARRIS CASTORO EYE AND LASER CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-399-8451
Mailing Address - Street 1:620 BOULTON ST
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4255
Mailing Address - Country:US
Mailing Address - Phone:410-893-0480
Mailing Address - Fax:410-893-9796
Practice Address - Street 1:620 BOULTON ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4255
Practice Address - Country:US
Practice Address - Phone:410-893-0480
Practice Address - Fax:410-893-9796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS719Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER