Provider Demographics
NPI:1770683898
Name:NEUBAUER, HANNAH YECHESKEL (OD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:YECHESKEL
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:11921 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2744
Mailing Address - Country:US
Mailing Address - Phone:301-984-3937
Mailing Address - Fax:301-987-4448
Practice Address - Street 1:11921 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2744
Practice Address - Country:US
Practice Address - Phone:301-984-3937
Practice Address - Fax:301-987-4448
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1733152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD298841S61OtherMEDICARE IDENTIFICATION NUMBER
MDG01480F01Medicare ID - Type Unspecified