Provider Demographics
NPI:1730234790
Name:HILLANDALE OPTICIANS,INC.
Entity type:Organization
Organization Name:HILLANDALE OPTICIANS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-439-1655
Mailing Address - Street 1:9412 CROSBY RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1539
Mailing Address - Country:US
Mailing Address - Phone:301-439-1655
Mailing Address - Fax:
Practice Address - Street 1:10149 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1713
Practice Address - Country:US
Practice Address - Phone:301-439-1655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06388098332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1158280001Medicare ID - Type Unspecified