Provider Demographics
NPI:1750987244
Name:SIRI PREMIER EYECARE
Entity type:Organization
Organization Name:SIRI PREMIER EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:240-486-0335
Mailing Address - Street 1:9566 WEDGE WAY
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:MD
Mailing Address - Zip Code:21875-2378
Mailing Address - Country:US
Mailing Address - Phone:240-486-0335
Mailing Address - Fax:
Practice Address - Street 1:724 CAMBRIDGE MARKETPLACE BLVD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613
Practice Address - Country:US
Practice Address - Phone:240-486-0335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty