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General NPI Number Information
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NPI Number | 1619009693
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Entity Type | Individual
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Provider Name | MAUREEN JUDITH KIMMETH O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 801 PENNSYLVANIA AVE NW STE 4A
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City | WASHINGTON
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State | DC
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Zip | 20004-2615
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Country | US
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Telephone | 202-783-5318
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Fax | 202-783-5319
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Provider Business Mailing Address
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Address Line | 701 PENNSYLVANIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20004-2608
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Country | US
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Telephone | 202-783-5318
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Fax | 202-783-5319
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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 | 1000016
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License Number State | DC
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