Basic Information
| Provider Information | |||||||||
| NPI: | 1700182151 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAGORI | ||||||||
| FirstName: | SAYA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12150 ANNAPOLIS RD STE 111 | ||||||||
| Address2: | |||||||||
| City: | GLENN DALE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207699183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017790844 | ||||||||
| FaxNumber: | 3017790744 | ||||||||
| Practice Location | |||||||||
| Address1: | 7305 BALTIMORE AVE STE 101 | ||||||||
| Address2: | |||||||||
| City: | COLLEGE PARK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017790844 | ||||||||
| FaxNumber: | 3017790744 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2011 | ||||||||
| LastUpdateDate: | 10/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | D0084815 | MD | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 556025000 | 05 | MD | MEDICAID |