Provider Demographics
NPI:1437329257
Name:SHALINI L. MAHARAJ O.D., LLC
Entity Type:Organization
Organization Name:SHALINI L. MAHARAJ O.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAHARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-336-6943
Mailing Address - Street 1:100 NEWMARKET SQ
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23605-2730
Mailing Address - Country:US
Mailing Address - Phone:757-825-3132
Mailing Address - Fax:
Practice Address - Street 1:100 NEWMARKET SQ
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23605-2730
Practice Address - Country:US
Practice Address - Phone:757-825-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001683152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty