Provider Demographics
NPI:1538241377
Name:NAIK, NIMA (OD)
Entity type:Individual
Prefix:
First Name:NIMA
Middle Name:
Last Name:NAIK
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 1:2500 CLARENDON BLVD
Mailing Address - Street 2:SUITE 423
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3850
Mailing Address - Country:US
Mailing Address - Phone:910-257-8036
Mailing Address - Fax:703-941-0229
Practice Address - Street 1:5901 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3211
Practice Address - Country:US
Practice Address - Phone:703-941-2008
Practice Address - Fax:703-941-0229
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist