Provider Demographics
NPI:1871848994
Name:SUTHERLAND, LYUDMILA (OD)
Entity Type:Individual
Prefix:DR
First Name:LYUDMILA
Middle Name:
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LYUDMILA
Other - Middle Name:
Other - Last Name:PHLIKHOVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:381 S WILLOW ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-5729
Practice Address - Country:US
Practice Address - Phone:703-847-8899
Practice Address - Fax:571-223-6780
Is Sole Proprietor?:No
Enumeration Date:2012-07-15
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4910152W00000X
NH1007152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist