Provider Demographics
NPI:1073286340
Name:MCGEARY, JUSTINE ELIZABETH (OD)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:ELIZABETH
Last Name:MCGEARY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:125 DANBURY RD STE 8
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4111
Practice Address - Country:US
Practice Address - Phone:203-438-5005
Practice Address - Fax:203-438-8403
Is Sole Proprietor?:No
Enumeration Date:2021-07-31
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV009403152W00000X
CT3234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist