Provider Demographics
NPI:1376546721
Name:DULANEY EYE INSTITUTE, LLC
Entity Type:Organization
Organization Name:DULANEY EYE INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-214-0144
Mailing Address - Street 1:901 DULANEY VALLEY RD
Mailing Address - Street 2:STE 220
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-0621
Mailing Address - Country:US
Mailing Address - Phone:410-583-1000
Mailing Address - Fax:410-583-4718
Practice Address - Street 1:901 DULANEY VALLEY RD
Practice Address - Street 2:STE 220
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-0621
Practice Address - Country:US
Practice Address - Phone:410-583-1000
Practice Address - Fax:410-583-4718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1161261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical