Provider Demographics
NPI:1669586590
Name:STEINLEITNER, MARIA DEE (OD)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DEE
Last Name:STEINLEITNER
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 1:1401 MALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-9125
Mailing Address - Country:US
Mailing Address - Phone:562-421-2757
Mailing Address - Fax:562-420-7267
Practice Address - Street 1:1401 MALL DRIVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-9125
Practice Address - Country:US
Practice Address - Phone:804-464-9124
Practice Address - Fax:804-464-9125
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT8329TPA152W00000X
VA061800200152W00000X
VA0119005380225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U73936Medicare UPIN
WOP8329BMedicare ID - Type Unspecified