Basic Information
Provider Information
NPI: 1740206846
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAPPERSTEIN
FirstName: ARNOLD
MiddleName: MARTIN
NamePrefix: DR.
NameSuffix:  
Credential: OD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6220 OLD DOBBIN LN
Address2:  
City: COLUMBIA
State: MD
PostalCode: 210455812
CountryCode: US
TelephoneNumber: 4108829600
FaxNumber: 6123670841
Practice Location
Address1: 7684 BELAIR RD
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212364088
CountryCode: US
TelephoneNumber: 4108829600
FaxNumber: 4108824917
Other Information
ProviderEnumerationDate: 07/14/2006
LastUpdateDate: 05/12/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XTA0593MDY Eye and Vision Services ProvidersOptometrist 
152W00000XOP342DCN Eye and Vision Services ProvidersOptometrist 
152W00000XOE004333TPAN Eye and Vision Services ProvidersOptometrist 

No ID Information.


Home