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General NPI Number Information
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NPI Number | 1396841979
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Entity Type | Individual
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Provider Name | SANDRA KAY MAROTTA OD
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Gender | Female
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 13029 LEE JACKSON MEMORIAL HWY
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City | FAIRFAX
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State | VA
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Zip | 22033-2001
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Country | US
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Telephone | 703-322-2020
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Fax | 703-322-1221
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Provider Business Mailing Address
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Address Line | 13029 LEE JACKSON MEMORIAL HWY
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City | FAIRFAX
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State | VA
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Zip | 22033-2001
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Country | US
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Telephone | 703-322-2020
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Fax | 703-322-1221
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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 | 0618000113
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License Number State | VA
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