Provider Demographics
NPI:1386393429
Name:ZAMANI, MARZIA (OD)
Entity type:Individual
Prefix:DR
First Name:MARZIA
Middle Name:
Last Name:ZAMANI
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 1:913 W COUNTRYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2905
Mailing Address - Country:US
Mailing Address - Phone:812-360-3098
Mailing Address - Fax:
Practice Address - Street 1:2552 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-5338
Practice Address - Country:US
Practice Address - Phone:812-332-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004320A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist