Provider Demographics
NPI:1508679424
Name:SINDELAR, JENNIFER GAIL
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GAIL
Last Name:SINDELAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 FERN CT
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-5987
Mailing Address - Country:US
Mailing Address - Phone:240-925-5195
Mailing Address - Fax:
Practice Address - Street 1:16375 MERCHANTS LN
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-5655
Practice Address - Country:US
Practice Address - Phone:540-413-3141
Practice Address - Fax:540-644-0719
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101004636156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician