Provider Demographics
NPI:1932277571
Name:SPECTACLE PLUS OPTICAL INC
Entity Type:Organization
Organization Name:SPECTACLE PLUS OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GINSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-881-5701
Mailing Address - Street 1:4701 RANDOLPH ROAD
Mailing Address - Street 2:G2
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2261
Mailing Address - Country:US
Mailing Address - Phone:301-881-7033
Mailing Address - Fax:301-881-5460
Practice Address - Street 1:4701 RANDOLPH ROAD
Practice Address - Street 2:G2
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2261
Practice Address - Country:US
Practice Address - Phone:301-881-7033
Practice Address - Fax:301-881-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0133400001OtherDME #