Provider Demographics
NPI:1912942632
Name:KASNER, CINDY DEUTSCH (OD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:DEUTSCH
Last Name:KASNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:CREDENTIALING DEPARTMENT
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-494-1324
Mailing Address - Fax:410-494-1361
Practice Address - Street 1:6412 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2308
Practice Address - Country:US
Practice Address - Phone:410-764-9360
Practice Address - Fax:410-764-3228
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1208152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD348388600Medicaid
MD348388600Medicaid
MD577ZMedicare PIN
MD110004975Medicare PIN
MD160447YA4UMedicare PIN