Provider Demographics
NPI:1013223338
Name:EYE DEAL VISION CENTER, LLC.
Entity Type:Organization
Organization Name:EYE DEAL VISION CENTER, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHWARTZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-843-1000
Mailing Address - Street 1:3005 LEONARDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3005 LEONARDTOWN RD
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3136
Practice Address - Country:US
Practice Address - Phone:301-645-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTORS ON SIGHT OPTOMETRISTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-24
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty