Provider Demographics
NPI:1609244649
Name:RUFARO MUDZINGANYAMA AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:RUFARO MUDZINGANYAMA AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:RUFARO
Authorized Official - Middle Name:
Authorized Official - Last Name:MUDZINGANYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-446-1154
Mailing Address - Street 1:8147 AUTUMN PL
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8147 AUTUMN PL
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-8258
Practice Address - Country:US
Practice Address - Phone:614-446-1154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5964152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty