Basic Information
| Provider Information | |||||||||
| NPI: | 1003960121 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASRANI | ||||||||
| FirstName: | SANJAY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 REGENCY PKWY STE 100 | ||||||||
| Address2: | DUKE EYE CENTER OF CARY | ||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275118712 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | DUKE EYE CENTER OF CARY | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196204467 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 05/28/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 2000-00351 | NC | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 8912603 | 05 | NC | MEDICAID |