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General NPI Number Information
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NPI Number | 1427797521
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Entity Type | Organization
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Legal Business Name | SANDRA NASSAR OD PLLC
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Dates
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Enumeration Date | 05/27/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 500 TYVOLA RD
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City | CHARLOTTE
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State | NC
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Zip | 28217-3504
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Country | US
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Telephone | 704-501-2406
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Fax |
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Provider Business Mailing Address
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Address Line | 1627 S MINT ST
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City | CHARLOTTE
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State | NC
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Zip | 28203-4301
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Country | US
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Telephone | 412-889-7420
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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. SANDRA NASSAR
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Credential | OD
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Telephone | 412-889-7420
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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 |
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License Number State |
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