Provider Demographics
NPI:1851762322
Name:DR MONICA CROSS DOCTOR OF OPTOMETRY INC
Entity Type:Organization
Organization Name:DR MONICA CROSS DOCTOR OF OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-476-1052
Mailing Address - Street 1:PO BOX 3022
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20709-3022
Mailing Address - Country:US
Mailing Address - Phone:301-476-1052
Mailing Address - Fax:
Practice Address - Street 1:15600 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1630
Practice Address - Country:US
Practice Address - Phone:301-476-1052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1146152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty