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Individual

AHAVA OPPENHEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
12621 WATERSPOUT CT, OWINGS MILLS, MD 21117-1028
(443) 621-0756
Mailing address
7028 WALLIS AVE, BALTIMORE, MD 21215-1711
(917) 406-8264

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
DA2274
MD
152W00000X
Optometrist
TUV006666
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02443158
NY
01
P00987185
RAILROAD MEDICARE
MD
Enumeration date
07/26/2006
Last updated
01/15/2012
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