Organization
WASHINGTON NATIONAL EYE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY M LUSTBADER MD (CHAIRMAN AND PRESIDENT)
(202) 877-5329
Entity
Organization
Contact information
Practice address
110 IRVING STREET, NW, SUITE 1A-19, WASHINGTON, DC 20010-2976
(202) 877-5329
(202) 877-7743
Mailing address
110 IRVING STREET, NW, SUITE 1A-19, WASHINGTON, DC 20010-2976
(202) 877-5329
(202) 877-7743
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
52132XXXX-53004998
DC
207W00000X
Ophthalmology Physician
Primary
52132XXXX53004998
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022986500
—
DC
01
—
486621500
MARYLAND MEDICAID
MD
05
—
486621500
—
MD
01
—
9935
BCBS
DC
Enumeration date
07/14/2006
Last updated
11/23/2016
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