Healthcare Provider Details

I. General information

NPI: 1285824219
Provider Name (Legal Business Name): RAJANISH SETTY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7347 BELL CREEK RD STE 200
MECHANICSVILLE VA
23111-3504
US

IV. Provider business mailing address

PO BOX 1290
FOREST VA
24551-1290
US

V. Phone/Fax

Practice location:
  • Phone: 804-746-5245
  • Fax:
Mailing address:
  • Phone: 434-385-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618001934
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: