Provider Demographics
NPI:1962809962
Name:KASPER LOEB & MILLER PA
Entity type:Organization
Organization Name:KASPER LOEB & MILLER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-437-4440
Mailing Address - Street 1:8556 FORT SMALLWOOD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2634
Mailing Address - Country:US
Mailing Address - Phone:410-437-4440
Mailing Address - Fax:410-437-2282
Practice Address - Street 1:8556 FORT SMALLWOOD RD
Practice Address - Street 2:SUITE A
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-2634
Practice Address - Country:US
Practice Address - Phone:410-437-4440
Practice Address - Fax:410-437-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD381182OtherMEDICARE
GADV3286OtherRAILROAD MEDICARE