MEDICARE: DR. CHRYSTYNA P. KUZMOWYCH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	625	VA

General Provider Information

NPI Number	:	1558368373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRYSTYNA P. KUZMOWYCH O.D.

Provider Business Mailing Address
First Line	:	9510 WOODY LN
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-2024
Country	:	US
Telephone Number	:	703-759-4865
Fax Number	:	703-757-9510

Provider Business Practice Location Address
First Line	:	9510 WOODY LN
Second Line	:
City	:	GREAT FALLS
State	:	VA
Zip	:	22066-2024
Country	:	US
Telephone Number	:	703-759-4865
Fax Number	:	703-757-9510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/21/2007

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