| |
20 E Baltimore Ave, Lansdowne, PA 19050-2202 | |
(610) 623-1127 | |
(484) 461-8618 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 20 E Baltimore Ave, Lansdowne, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376563148 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OEG000100 (Pennsylvania) | Primary |
Provider Name | Michael B Maizel |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902829518 PECOS PAC ID: 4880660133 Enrollment ID: I20040909000019 |
Mailing Address | Practice Location Address |
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20 E Baltimore Ave, Lansdowne, PA 19050-2202 Ph: (610) 623-1127 | 20 E Baltimore Ave, Lansdowne, PA 19050-2202 Ph: (610) 623-1127 |
Michael B Maizel, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 20 E Baltimore Ave, Lansdowne, PA 19050 Phone: 610-623-1127 Fax: 484-461-8618 |