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General NPI Number Information
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NPI Number | 1063424406
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Entity Type | Individual
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Provider Name | RANA IMAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 05/18/2020
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Provider Practice Location Address
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Address Line | 8990 FERN PARK DR SUITE A
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City | BURKE
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State | VA
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Zip | 22015-2539
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Country | US
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Telephone | 703-425-0600
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Fax | 703-425-3982
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Provider Business Mailing Address
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Address Line | 8990 FERN PARK DR SUITE A
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City | BURKE
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State | VA
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Zip | 22015-2539
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Country | US
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Telephone | 703-425-0600
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Fax | 703-425-3982
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001010
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License Number State | VA
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