Provider Demographics
NPI:1598085565
Name:KUMAR, SAPNA T (OD)
Entity Type:Individual
Prefix:
First Name:SAPNA
Middle Name:T
Last Name:KUMAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SAPNA
Other - Middle Name:T
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3553 SAINT ALBANS RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-1551
Mailing Address - Country:US
Mailing Address - Phone:216-236-3727
Mailing Address - Fax:216-916-9158
Practice Address - Street 1:8300 HOUGH AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4247
Practice Address - Country:US
Practice Address - Phone:216-231-7700
Practice Address - Fax:216-231-7920
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5972152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3142432Medicaid