Provider Demographics
NPI:1679971014
Name:APPELBAUM EYECARE ASSOCIATES
Entity type:Organization
Organization Name:APPELBAUM EYECARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:APPELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-897-8484
Mailing Address - Street 1:6509 DEMOCRACY BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1639
Mailing Address - Country:US
Mailing Address - Phone:301-897-8484
Mailing Address - Fax:
Practice Address - Street 1:6509 DEMOCRACY BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1639
Practice Address - Country:US
Practice Address - Phone:301-897-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-17
Last Update Date:2014-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0660152WV0400X
MDTA2139152WV0400X
MD01197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1699847897OtherNPI NUMBER
MD632708029OtherNPI NUMBER
MD176220OtherMEDICARE PTAN
MD1568538874OtherNPI NUMBER