Provider Demographics
NPI:1548364045
Name:ASSOCIATED EYE CARE OPTOMETRY PA
Entity type:Organization
Organization Name:ASSOCIATED EYE CARE OPTOMETRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LOSKOT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-569-7173
Mailing Address - Street 1:2227 OLD EMMORTON RD
Mailing Address - Street 2:STE 114
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6190
Mailing Address - Country:US
Mailing Address - Phone:410-569-7173
Mailing Address - Fax:410-569-7123
Practice Address - Street 1:2227 OLD EMMORTON RD
Practice Address - Street 2:STE 114
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6187
Practice Address - Country:US
Practice Address - Phone:410-569-7173
Practice Address - Fax:410-569-7123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD 1466152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAE07961OtherSPECTERA
MD115934OtherEYEMED
MD49888OtherDAVIS
MDLN09ASOtherCAREFIRST BCBSMD
MDT618OtherCFBCBS NASCO
MD803716OtherEHP JHHC
MDLN09ASOtherCAREFIRST BCBSMD
MD803716OtherEHP JHHC
MD920LMedicare PIN