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General NPI Number Information
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NPI Number | 1942867981
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Entity Type | Individual
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Provider Name | SYDNEY RAE CHADO OD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2019
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1150 PROFESSIONAL CT STE B
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City | HAGERSTOWN
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State | MD
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Zip | 21740-4100
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Country | US
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Telephone | 301-797-8788
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Fax | 301-797-2218
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Provider Business Mailing Address
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Address Line | 1150 PROFESSIONAL CT STE B
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City | HAGERSTOWN
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State | MD
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Zip | 21740-4100
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Country | US
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Telephone | 301-797-8788
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Fax | 301-797-2218
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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 | OEG003726
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA2749
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License Number State | MD
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