Provider Demographics
NPI:1629719455
Name:DR RIZWANA IQBAL LLC
Entity Type:Organization
Organization Name:DR RIZWANA IQBAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIZWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:443-278-3465
Mailing Address - Street 1:9 EDEN TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3480
Mailing Address - Country:US
Mailing Address - Phone:443-278-3365
Mailing Address - Fax:
Practice Address - Street 1:9901 YORK RD
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3407
Practice Address - Country:US
Practice Address - Phone:443-278-3365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty