Provider Demographics
NPI:1316419773
Name:CENTER FOR VISION DEVELOPMENT AND REHABILITATION
Entity type:Organization
Organization Name:CENTER FOR VISION DEVELOPMENT AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:BENSHIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-865-1800
Mailing Address - Street 1:164 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6279
Mailing Address - Country:US
Mailing Address - Phone:301-865-1800
Mailing Address - Fax:301-865-1973
Practice Address - Street 1:164 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6279
Practice Address - Country:US
Practice Address - Phone:301-865-1800
Practice Address - Fax:301-865-1973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty