Provider Demographics
NPI:1639584063
Name:MCGARVEY, SVETLANA ROYTMAN (OD)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:ROYTMAN
Last Name:MCGARVEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SVETLANA
Other - Middle Name:
Other - Last Name:ROYTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:36800 PEPPER DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2459
Mailing Address - Country:US
Mailing Address - Phone:440-463-0065
Mailing Address - Fax:
Practice Address - Street 1:7850 MENTOR AVE STE 566
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5580
Practice Address - Country:US
Practice Address - Phone:440-974-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6315152W00000X
IL046010959152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0757500001Medicare NSC
IL210209Medicare PIN