1790914463 NPI number — KRISTINA L. RAMSEY, O.D., P.C.

Table of content: (NPI 1790914463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790914463 NPI number — KRISTINA L. RAMSEY, O.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KRISTINA L. RAMSEY, O.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HARBOR FAMILY EYE CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790914463
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6313
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23703-0313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-393-2797
Provider Business Mailing Address Fax Number:
757-277-0108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1098 FREDERICK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23707-4119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-393-2797
Provider Business Practice Location Address Fax Number:
757-277-0108
Provider Enumeration Date:
07/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAMSEY
Authorized Official First Name:
KRISTINA
Authorized Official Middle Name:
LYNETTE
Authorized Official Title or Position:
OWNER-OPTOMETRIST
Authorized Official Telephone Number:
757-393-2797

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  0618001673 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)