Provider Demographics
NPI:1902036437
Name:BUDNER & ASSOCIATES O.D. P.A.
Entity Type:Organization
Organization Name:BUDNER & ASSOCIATES O.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUDNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-691-8008
Mailing Address - Street 1:4084 UNIVERSITY DR
Mailing Address - Street 2:204
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6803
Mailing Address - Country:US
Mailing Address - Phone:703-691-8008
Mailing Address - Fax:
Practice Address - Street 1:4084 UNIVERSITY DR
Practice Address - Street 2:204
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6803
Practice Address - Country:US
Practice Address - Phone:703-691-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA1108152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9205179Medicaid
VA9205179Medicaid