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General NPI Number Information
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NPI Number | 1972025104
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Entity Type | Individual
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Provider Name | DEENA GHAZZI
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Gender | Female
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 40 YORK RD STE 500
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City | TOWSON
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State | MD
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Zip | 21204-5243
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Country | US
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Telephone | 410-616-9952
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 6TH AVE STE 119B
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City | YORK
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State | PA
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Zip | 17403-2627
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Country | US
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Telephone | 717-650-6148
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Fax |
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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 | OEG003292
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License Number State | PA
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