Provider Demographics
NPI:1235427733
Name:HOSSEINI, SUE (OPTICIAN)
Entity Type:Individual
Prefix:MRS
First Name:SUE
Middle Name:
Last Name:HOSSEINI
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 UNIVERSITY BLVD E STE 159
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4606
Mailing Address - Country:US
Mailing Address - Phone:301-445-5340
Mailing Address - Fax:240-450-3376
Practice Address - Street 1:1425 UNIVERSITY BLVD E STE 159
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4606
Practice Address - Country:US
Practice Address - Phone:301-445-5340
Practice Address - Fax:240-450-3376
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician