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Organization

NEW VISIONS OPTICAL, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SANTANA LAVON NOTTAGE (PRESIDENT/CEO)
(443) 315-5945
Entity
Organization

Contact information

Practice address
5310 EDMONDSON AVE, BALTIMORE, MD 21229-2201
(443) 315-5945
(800) 670-8788
Mailing address
5310 EDMONDSON AVE, BALTIMORE, MD 21229-2201
(443) 315-5945
(800) 670-8788

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
03695969
MD
332H00000X
Eyewear Supplier
Primary
03695969
MD

Other

Enumeration date
06/12/2013
Last updated
07/01/2013
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