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General NPI Number Information
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NPI Number | 1508755687
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Entity Type | Organization
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Legal Business Name | EYESINGH, LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 3625 DALLAS HWY SW STE 660
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City | MARIETTA
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State | GA
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Zip | 30064-5906
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Country | US
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Telephone | 770-590-8951
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Fax | 770-214-4668
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Provider Business Mailing Address
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Address Line | 5331 TALLGRASS WAY NW
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City | KENNESAW
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State | GA
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Zip | 30152-2832
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Country | US
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Telephone | 678-570-4762
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Fax | 678-570-4762
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMBAREEN MOHAMED
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Credential | OD
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Telephone | 678-570-4762
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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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