Organization
CHIPPEWA OPTICAL LLC
Active
Other names
ActualEyes
Organization subpart
No
Provider details
NPI number
Authorized official
DOVID PINCHUS BERKOVITS (MEMBER)
(410) 406-7951
Entity
Organization
Contact information
Practice address
305 REISTERSTOWN RD, BALTIMORE, MD 21208-5313
(410) 406-7951
(443) 648-9001
Mailing address
305 REISTERSTOWN RD, PIKESVILLE, MD 21208-5313
(410) 406-7951
(443) 648-9001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
156FX1800X
Optician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
555350400
—
MD
Enumeration date
11/21/2017
Last updated
12/21/2021
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