Organization
MODERN EYES, LLC
Active
Other names
Modern Eyes
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK P BORSUK O.D. (OWNER)
(240) 631-2255
Entity
Organization
Contact information
Practice address
108 OLDE TOWNE AVE, STE. 16, GAITHERSBURG, MD 20877-2095
(240) 631-2255
Mailing address
108 OLDE TOWNE AVE, STE. 16, GAITHERSBURG, MD 20877-2095
(240) 631-2255
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1522
MD
152WV0400X
Vision Therapy Optometrist
TA1522
MD
Other
Enumeration date
01/15/2007
Last updated
12/14/2007
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