Organization
NORTHEAST OPTICAL
Active
Organization
NORTHEAST OPTICAL
Active
Other names
Linda Fundenberger MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA FUNDENBERGER M.D. (OWNER)
(317) 547-5525
Entity
Organization
Contact information
Practice address
2815 E 38TH ST, INDIANAPOLIS, IN 46218-1229
(317) 547-5525
(317) 543-0948
Mailing address
2815 E 38TH ST, INDIANAPOLIS, IN 46218-1229
(317) 547-5525
(317) 543-0948
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
01036129A
IN
332H00000X
Eyewear Supplier
01036129A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100176610A
—
IN
Enumeration date
04/26/2007
Last updated
06/21/2013
Update your record
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