MEDICARE: DR. NIMI SIKRI OD

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	152W00000X	Optometrist	TA2662	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0618001824	OTHER	VA	LICENSE
2	TA2662	OTHER	MD	LICENSE

General Provider Information

NPI Number	:	1912148560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIMI SIKRI OD

Provider Business Mailing Address
First Line	:	1405 S FERN ST # 273
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-2810
Country	:	US
Telephone Number	:	301-341-6753
Fax Number	:	301-341-6754

Provider Business Practice Location Address
First Line	:	2400 FIVE LEES LN
Second Line	:
City	:	GLENARDEN
State	:	MD
Zip	:	20706-1617
Country	:	US
Telephone Number	:	301-341-6753
Fax Number	:

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

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	06/30/2019

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