Organization
PENN OPTICAL CO. LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD BRADLEY FUSS O.D. (PRESIDENT)
(410) 327-7070
Entity
Organization
Contact information
Practice address
2122 E MONUMENT ST, BALTIMORE, MD 21205-2334
(410) 327-7070
(410) 327-7072
Mailing address
5006 SINCLAIR LN, BALTIMORE, MD 21206-5936
(410) 488-6800
(410) 488-4270
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
—
Other
Enumeration date
09/20/2007
Last updated
09/20/2007
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