Basic Information
| Provider Information | |||||||||
| NPI: | 1477938520 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POSSE | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | MARCEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8614 WESTWOOD CENTER DR FL 9 | ||||||||
| Address2: | |||||||||
| City: | VIENNA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221822442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038478899 | ||||||||
| FaxNumber: | 5712236780 | ||||||||
| Practice Location | |||||||||
| Address1: | 1776 EYE ST NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200063700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2023313931 | ||||||||
| FaxNumber: | 2023313932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2015 | ||||||||
| LastUpdateDate: | 06/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC5102 | FL | N | Eye and Vision Services Providers | Optometrist | 152W00000X | TA2622 | MD | N | Eye and Vision Services Providers | Optometrist | 152W00000X | OP1000429 | DC | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.