Provider Demographics
NPI:1477512648
Name:MAGAZINER, HARVEY EARL (OD)
Entity Type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:EARL
Last Name:MAGAZINER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FALLING LEAF CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1602
Mailing Address - Country:US
Mailing Address - Phone:301-829-2221
Mailing Address - Fax:301-831-4040
Practice Address - Street 1:1517 RIDGESIDE DR
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5280
Practice Address - Country:US
Practice Address - Phone:301-829-2221
Practice Address - Fax:301-831-4040
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0602152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD079N955FMedicare ID - Type Unspecified
MDT30977Medicare UPIN