Provider Demographics
NPI:1457978504
Name:PRASAIN, SADIKSHA (OD)
Entity Type:Individual
Prefix:DR
First Name:SADIKSHA
Middle Name:
Last Name:PRASAIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4238 WILSON BLVD STE 1220
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1833
Mailing Address - Country:US
Mailing Address - Phone:703-236-3169
Mailing Address - Fax:
Practice Address - Street 1:4238 WILSON BLVD STE 1220
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1833
Practice Address - Country:US
Practice Address - Phone:701-236-3169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-05
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-E58152W00000X
VA0618003151152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist