Provider Demographics
NPI:1366127441
Name:SCHIFSKY, LOTUS TIAN EN (OD)
Entity type:Individual
Prefix:DR
First Name:LOTUS
Middle Name:TIAN EN
Last Name:SCHIFSKY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:403 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1127
Mailing Address - Country:US
Mailing Address - Phone:502-647-3937
Mailing Address - Fax:502-633-7326
Practice Address - Street 1:3701 HOPEWELL RD STE 900
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-5395
Practice Address - Country:US
Practice Address - Phone:502-398-3937
Practice Address - Fax:502-633-7326
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN18004419152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist