Provider Demographics
NPI:1538364906
Name:NARULA, REENA (OD)
Entity type:Individual
Prefix:
First Name:REENA
Middle Name:
Last Name:NARULA
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 1:1 HATFIELD LN, SUITE 3
Mailing Address - Street 2:EYE PHYSICIANS OF ORANGE COUNTY, P.C.
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924
Mailing Address - Country:US
Mailing Address - Phone:845-294-5128
Mailing Address - Fax:845-294-1479
Practice Address - Street 1:1 HATFIELD LN, SUITE 3
Practice Address - Street 2:EYE PHYSICIANS OF ORANGE COUNTY, P.C.
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924
Practice Address - Country:US
Practice Address - Phone:845-294-5128
Practice Address - Fax:845-294-1479
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV-007037152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03103188Medicaid
A400006082Medicare UPIN