Provider Demographics
NPI:1235784497
Name:NARAYANAN, MALVIKA (OD)
Entity Type:Individual
Prefix:DR
First Name:MALVIKA
Middle Name:
Last Name:NARAYANAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2069 CRIST DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-7228
Mailing Address - Country:US
Mailing Address - Phone:650-305-9506
Mailing Address - Fax:
Practice Address - Street 1:54 W BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4018
Practice Address - Country:US
Practice Address - Phone:718-299-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009037152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist