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General NPI Number Information
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NPI Number | 1386393429
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Entity Type | Individual
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Provider Name | MARZIA ZAMANI OD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 2552 E 3RD ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5338
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Country | US
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Telephone | 812-332-3432
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Fax |
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Provider Business Mailing Address
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Address Line | 913 W COUNTRYSIDE LN
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City | BLOOMINGTON
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State | IN
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Zip | 47403-2905
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Country | US
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Telephone | 812-360-3098
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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 | 18004320A
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License Number State | IN
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