Provider Demographics
NPI:1275117731
Name:ISEE VISION CENTER
Entity Type:Organization
Organization Name:ISEE VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLANREWAJU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-918-0095
Mailing Address - Street 1:6615 RIVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2908
Mailing Address - Country:US
Mailing Address - Phone:301-918-0095
Mailing Address - Fax:410-874-8599
Practice Address - Street 1:6615 RIVERDALE RD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-2908
Practice Address - Country:US
Practice Address - Phone:301-918-0095
Practice Address - Fax:410-874-8599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty