Provider Demographics
NPI:1942867981
Name:CHADO, SYDNEY RAE (OD)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:RAE
Last Name:CHADO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:RAE
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1150 PROFESSIONAL CT STE B
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4100
Mailing Address - Country:US
Mailing Address - Phone:301-797-8788
Mailing Address - Fax:301-797-2218
Practice Address - Street 1:1150 PROFESSIONAL CT STE B
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4100
Practice Address - Country:US
Practice Address - Phone:301-797-8788
Practice Address - Fax:301-797-2218
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003726152W00000X
MDTA2749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist