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General NPI Number Information
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NPI Number | 1972580124
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Entity Type | Individual
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Provider Name | SUSAN J PIETROWSKI OD
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Gender | Female
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 3437 FRANCES BERKELEY
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-1334
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Country | US
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Telephone | 320-260-7515
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Fax |
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Provider Business Mailing Address
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Address Line | 3437 FRANCES BERKELEY
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-1334
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Country | US
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Telephone | 320-260-7515
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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 | 2877
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License Number State | MN
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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 | 0618001739
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License Number State | VA
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