1952435620 NPI number — PADMINI R NATHAN, OPTOMETRISTS, P.A.

Table of content: (NPI 1952435620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952435620 NPI number — PADMINI R NATHAN, OPTOMETRISTS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PADMINI R NATHAN, OPTOMETRISTS, P.A.
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:
DRS. EVICH, & NATHAN, OPTOMETRISTS, P.A.
Provider Other Organization Name Type Code:
4
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:
1952435620
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
73 THOMAS JOHNSON DR STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-662-1601
Provider Business Mailing Address Fax Number:
301-695-9149

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 THOMAS JOHNSON DR STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-662-1601
Provider Business Practice Location Address Fax Number:
301-695-9149
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NATHAN
Authorized Official First Name:
PADMINI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DOCTOR
Authorized Official Telephone Number:
301-662-1601

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  TA0563 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: TA1408 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: TA0842 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: TA1949 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152WC0802X , with the licence number: TA0563 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WC0802X , with the licence number: TA0842 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WL0500X , with the licence number: TA0563 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WP0200X , with the licence number: TA0563 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WS0006X , with the licence number: TA0563 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WV0400X , with the licence number: TA0563 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WX0102X , with the licence number: TA0563 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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