Basic Information
| Provider Information | |||||||||
| NPI: | 1629740840 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOSEPH | ||||||||
| FirstName: | BETHEL | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1701 E WEST HWY APT 418 | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209103057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132127906 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8551 SENTON ST | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015851080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2021 | ||||||||
| LastUpdateDate: | 10/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | TA2828 | MD | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.