# WASHINGTON NATIONAL EYE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437175684
- **Authorized official:** DR. JAY M LUSTBADER MD (CHAIRMAN AND PRESIDENT)
- **Authorized official phone:** (202) 877-5329

## Contact information

- **Practice address:** 110 IRVING STREET, NW, SUITE 1A-19, WASHINGTON, DC 20010-2976
- **Practice address phone:** (202) 877-5329
- **Practice address fax:** (202) 877-7743
- **Mailing address:** 110 IRVING STREET, NW, SUITE 1A-19, WASHINGTON, DC 20010-2976
- **Mailing address phone:** (202) 877-5329
- **Mailing address fax:** (202) 877-7743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 52132XXXX-53004998 | DC | — |
| 207W00000X | Ophthalmology Physician | 52132XXXX53004998 | DC | Yes |

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 11/23/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 022986500 | — | DC |
| 01 | — | 486621500 | MARYLAND MEDICAID | MD |
| 05 | — | 486621500 | — | MD |
| 01 | — | 9935 | BCBS | DC |