Provider Demographics
NPI:1306828025
Name:CHOWDHARY, GEETA (OD)
Entity Type:Individual
Prefix:
First Name:GEETA
Middle Name:
Last Name:CHOWDHARY
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 1:4351 THE CIRCLE AT NORTH HILLS ST STE 107
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5751
Mailing Address - Country:US
Mailing Address - Phone:919-782-9091
Mailing Address - Fax:919-782-9135
Practice Address - Street 1:4351 THE CIRCLE AT NORTH HILLS ST STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5751
Practice Address - Country:US
Practice Address - Phone:919-782-9091
Practice Address - Fax:919-782-9135
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1978152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCV00283Medicare UPIN