Basic Information
Provider Information
NPI: 1033558960
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUMARI
FirstName: RAJNI
MiddleName: BALA
NamePrefix: DR.
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2095 VOORHEES TOWN CENTER
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080432507
CountryCode: US
TelephoneNumber: 8567726331
FaxNumber:  
Practice Location
Address1: 2095 VOORHEES TOWN CTR
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080431910
CountryCode: US
TelephoneNumber: 8567726331
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2013
LastUpdateDate: 01/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XOEG002821PAY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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