Provider Demographics
NPI:1063415511
Name:KAPLAN, STANLEY (OD)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 CONNECTICUT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2765
Mailing Address - Country:US
Mailing Address - Phone:202-686-0200
Mailing Address - Fax:202-966-3327
Practice Address - Street 1:5415 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2765
Practice Address - Country:US
Practice Address - Phone:202-686-0200
Practice Address - Fax:202-966-3327
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-28
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP415152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1063415511Medicaid
DC0153200001Medicare NSC
DCKA177460Medicare PIN