IndividualActive
Mike Pelivanis, LDO
NPI 1407997992 · Optician · Washington, DC
Provider details
- NPI number
- 1407997992
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Credential
- LDO
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
4200 Wisconsin Ave Nw
Washington, DC 20016-2143
Phone: (202) 244-1308
Fax: (202) 244-2050
Approximate (ZIP-level) locationGet directions
Mailing address
4200 Wisconsin Ave Nw
Washington, DC 20016-2143
Registry dates
- Enumerated
- 2007-02-09
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.