Provider Demographics
NPI:1295622298
Name:GHIMIRE, MONICA (OPTOMETRIST)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:GHIMIRE
Suffix:
Gender:F
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 LONGLEAF LN
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-6515
Mailing Address - Country:US
Mailing Address - Phone:678-469-5988
Mailing Address - Fax:
Practice Address - Street 1:4153 LAVISTA RD STE C
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5344
Practice Address - Country:US
Practice Address - Phone:770-939-8828
Practice Address - Fax:770-939-3966
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist