Provider Demographics
NPI:1952035206
Name:PERSONALEYES LLC
Entity Type:Organization
Organization Name:PERSONALEYES LLC
Other - Org Name:IDEAL FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:SOLOMON
Authorized Official - Last Name:ZUCKERBROD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-428-4182
Mailing Address - Street 1:2529 FARRINGDON RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2547
Mailing Address - Country:US
Mailing Address - Phone:410-428-4182
Mailing Address - Fax:
Practice Address - Street 1:1860 REISTERSTOWN RD STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-1335
Practice Address - Country:US
Practice Address - Phone:410-428-4182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty