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General NPI Number Information
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NPI Number | 1316044498
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Entity Type | Organization
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Legal Business Name | SUZANNE CARDUCCI, O.D., L.L.C.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 701 RUSSELL AVE
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2631
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Country | US
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Telephone | 301-963-0050
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Fax | 301-963-7773
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Provider Business Mailing Address
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Address Line | PO BOX 15
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City | HIGHLAND
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State | MD
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Zip | 20777-0015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUZANNE CARDUCCI
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Credential | O.D.
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Telephone | 301-963-0050
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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 | TA983
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License Number State | MD
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