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General NPI Number Information
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NPI Number | 1972080869
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Entity Type | Organization
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Legal Business Name | NV OPTOMETRY
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 2626 BRANDERMILL BLVD
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City | GAMBRILLS
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State | MD
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Zip | 21054-1651
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Country | US
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Telephone | 410-451-9499
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Fax | 301-261-6584
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Provider Business Mailing Address
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Address Line | 1623 GRAND MEADOW DR
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City | GAMBRILLS
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State | MD
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Zip | 21054-2043
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Country | US
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Telephone | 240-643-1056
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | DR. NISHITH G PATEL
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Credential | OD
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Telephone | 240-643-1056
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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 | TA2261
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License Number State | MD
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