Provider Demographics
NPI:1609891811
Name:LALCHANDANI-LALWANI, GEETA ARJAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:GEETA
Middle Name:ARJAN
Last Name:LALCHANDANI-LALWANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 VIVIAN ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3217
Mailing Address - Country:US
Mailing Address - Phone:303-900-8507
Mailing Address - Fax:303-578-2173
Practice Address - Street 1:4430 ARAPAHOE AVE STE 115
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1100
Practice Address - Country:US
Practice Address - Phone:303-900-8507
Practice Address - Fax:303-578-2173
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94115207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274640900Medicaid
FL37044Medicare ID - Type Unspecified
FL274640900Medicaid
FL72148Medicare PIN