Athelli, Jeetandra M.

Athelli, Jeetandra M. is an sole proprietor health care provider with primary practice located at 14161A Robert Paris Ct , Chantilly VA 20151-4204. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Athelli, Jeetandra M. can be contacted via phone (703) 631-0014.

Contact Information

Primary practice address
14161A Robert Paris Ct Chantilly VA 20151-4204
Phone: (703) 631-0014
Fax: (703) 449-8770
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618000308 Virginia

Profile Details

NPI number 1902808181
LBN Legal business name Athelli, Jeetandra M.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2005
Last updated Jul 8th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902808181 NPPES
Virginia Other 437150 ANTHEMBLUECROSSBLUESHIELD

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