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General NPI Number Information
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NPI Number | 1366173718
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Entity Type | Individual
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Provider Name | LAKSHMISAHITHI RANI JAEEL OD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1305 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10021-5663
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Country | US
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Telephone | 466-962-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 595 DEAN ST APT 104
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City | BROOKLYN
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State | NY
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Zip | 11238-7479
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Country | US
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Telephone | 909-755-6070
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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 | 009638
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 9638
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License Number State | NY
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