Provider Demographics
NPI:1013204684
Name:SZYMANOWICZ NAGY, DORA G (OD)
Entity Type:Individual
Prefix:DR
First Name:DORA
Middle Name:G
Last Name:SZYMANOWICZ NAGY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DORA
Other - Middle Name:G
Other - Last Name:SZYMANOWICZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:11260 WHITE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742
Mailing Address - Country:US
Mailing Address - Phone:916-724-2265
Mailing Address - Fax:
Practice Address - Street 1:11260 WHITE ROCK RD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742
Practice Address - Country:US
Practice Address - Phone:916-724-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007714152WV0400X
CA14889TLG152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy