Healthcare Provider Details

I. General information

NPI: 1396789673
Provider Name (Legal Business Name): CORNEA CONSULTANTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8138 WATSON ST
MC LEAN VA
22102-4416
US

IV. Provider business mailing address

8138 WATSON ST
MC LEAN VA
22102-4416
US

V. Phone/Fax

Practice location:
  • Phone: 703-827-5454
  • Fax: 703-827-5539
Mailing address:
  • Phone: 703-827-5454
  • Fax: 703-827-5539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJESH KUMAR RAJPAL
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 703-827-5454