Provider Demographics
NPI:1407251788
Name:SANAGA OPTICAL & EYE CARE
Entity Type:Organization
Organization Name:SANAGA OPTICAL & EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LENO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-233-8222
Mailing Address - Street 1:2483 FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2856
Mailing Address - Country:US
Mailing Address - Phone:410-233-8222
Mailing Address - Fax:
Practice Address - Street 1:2483 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2856
Practice Address - Country:US
Practice Address - Phone:410-233-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SANAGA OPTICAL & EYE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty