Provider Demographics
NPI:1285828210
Name:KORMAN OPTOMETRY, LTD
Entity Type:Organization
Organization Name:KORMAN OPTOMETRY, LTD
Other - Org Name:EYE STUDIO AT ANTHEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:FARBER
Authorized Official - Last Name:KORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-459-3937
Mailing Address - Street 1:2870 BICENTENNIAL PKWY
Mailing Address - Street 2:STE 130
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-4480
Mailing Address - Country:US
Mailing Address - Phone:702-459-3937
Mailing Address - Fax:
Practice Address - Street 1:2870 BICENTENNIAL PKWY
Practice Address - Street 2:STE 130
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-4480
Practice Address - Country:US
Practice Address - Phone:702-459-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV104724Medicare PIN
NV6035130001Medicare NSC