Basic Information
Provider Information
NPI: 1003011040
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHITKARA
FirstName: MONICA
MiddleName: RANI
NamePrefix:  
NameSuffix:  
Credential: OD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CHITKARA
OtherFirstName: ARCHANA
OtherMiddleName: RANI
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 2296 HETTER ST
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432289151
CountryCode: US
TelephoneNumber: 6143530797
FaxNumber:  
Practice Location
Address1: 5555 HILLIARD ROME OFFICE PARK
Address2:  
City: HILLIARD
State: OH
PostalCode: 430267287
CountryCode: US
TelephoneNumber: 6147771111
FaxNumber: 6147777920
Other Information
ProviderEnumerationDate: 06/19/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X4630T1383OHY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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