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General NPI Number Information
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NPI Number | 1346391893
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Entity Type | Individual
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Provider Name | HOMA JULIE NIAZI O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 701 RUSSELL AVE LENSCRAFTERS, LAKEFOREST MALL
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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 | 13016 TAMARACK RD
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City | SILVER SPRING
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State | MD
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Zip | 20904-1543
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Country | US
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Telephone | 301-257-3831
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Fax |
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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 | TA1896
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License Number State | MD
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