Organization
WASHINGTON EYE SPECIALISTS
Active
Other names
Washington Eyeglass Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE GANCAYCO MD (PHYSICIAN)
(202) 529-5200
Entity
Organization
Contact information
Practice address
1160 VARNUM ST NE, STE 011, WASHINGTON, DC 20017-2107
(202) 529-5200
(202) 529-1476
Mailing address
1160 VARNUM ST NE, STE 011, WASHINGTON, DC 20017-2107
(202) 529-5200
(202) 529-1476
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17247
CHARTERED HEALTH
DC
01
—
27558
CHARTERED HEALTH
DC
05
—
388000100
—
MD
01
—
71730002
BLUE CROSS BLUE SHIELD
DC
01
—
G02434
MEDICARE P-TAN
DC
01
—
MD2417
EYEMED
DC
01
—
MD5025
EYEMED
DC
Enumeration date
03/30/2012
Last updated
03/30/2012
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