Provider Demographics
NPI:1639231491
Name:IRWIN AZMAN O.D. AND THOMAS AZMAN O.D.
Entity Type:Organization
Organization Name:IRWIN AZMAN O.D. AND THOMAS AZMAN O.D.
Other - Org Name:AZMAN EYE CARE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-561-8050
Mailing Address - Street 1:7 CENTER PL
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-4304
Mailing Address - Country:US
Mailing Address - Phone:410-285-3900
Mailing Address - Fax:410-285-5084
Practice Address - Street 1:7 CENTER PL
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-4304
Practice Address - Country:US
Practice Address - Phone:410-285-3900
Practice Address - Fax:410-285-5084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD719152W00000X
MD678152W00000X
MD515152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty