MEDICARE: HOWARD JOEL KAHN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1123	VA

General Provider Information

NPI Number	:	1285615815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD JOEL KAHN O.D.

Provider Business Mailing Address
First Line	:	9247 OLD KEENE MILL RD
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-4202
Country	:	US
Telephone Number	:	703-644-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	9247 OLD KEENE MILL RD
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-4202
Country	:	US
Telephone Number	:	703-644-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	08/27/2007

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