Organization
INTERNATIONAL EYE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SELVIN GNANAKKAN OD (OPTOMETRIST/PRESIDENT)
(602) 770-9300
Entity
Organization
Contact information
Practice address
4000 OLD COURT RD, SUITE 204, PIKESVILLE, MD 21208-2800
(410) 653-2400
(602) 535-3165
Mailing address
1135 REGINA DR, HALETHORPE, MD 21227-2342
(602) 770-9300
(602) 535-3165
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
207W00000X
Ophthalmology Physician
—
—
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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