Healthcare Provider Details

I. General information

NPI: 1023239571
Provider Name (Legal Business Name): PIONEER INTERNATIONAL TRADING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W EDMONSTON DR STE 103
ROCKVILLE MD
20852-1253
US

IV. Provider business mailing address

50 W EDMONSTON DR STE 103
ROCKVILLE MD
20852-1253
US

V. Phone/Fax

Practice location:
  • Phone: 301-251-6735
  • Fax:
Mailing address:
  • Phone: 301-251-6735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARYN TSAO
Title or Position: OPTOMETRIST
Credential: OD
Phone: 301-251-6735