Provider Demographics
NPI:1467782383
Name:HJELMGREN MCCARTHY, CHANDA (OD)
Entity Type:Individual
Prefix:MS
First Name:CHANDA
Middle Name:
Last Name:HJELMGREN MCCARTHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHANDA
Other - Middle Name:LEE
Other - Last Name:HJELMGREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3990
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:703-991-0514
Practice Address - Street 1:22000 DULLES RETAIL PLZ
Practice Address - Street 2:SUITE 168
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2512
Practice Address - Country:US
Practice Address - Phone:703-421-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001402152W00000X
FLOPC 3803152W00000X
DCOP1000090152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist