Healthcare Provider Details

I. General information

NPI: 1679167860
Provider Name (Legal Business Name): IQRA UDDIN RAFAT OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IQRA UDDIN OD

II. Dates (important events)

Enumeration Date: 02/27/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 MCTIGUE DR
TOLEDO OH
43615-5164
US

IV. Provider business mailing address

5648 CRICKET LN
BENSALEM PA
19020-3045
US

V. Phone/Fax

Practice location:
  • Phone: 419-442-7702
  • Fax: 419-225-8878
Mailing address:
  • Phone: 732-822-6496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.007528
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: