Healthcare Provider Details

I. General information

NPI: 1447429444
Provider Name (Legal Business Name): KOTECHA EYE & LASER CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 FAIRFAX DR
ARLINGTON VA
22203-1762
US

IV. Provider business mailing address

3801 FAIRFAX DR SUITE 74
ARLINGTON VA
22203-1762
US

V. Phone/Fax

Practice location:
  • Phone: 703-528-3910
  • Fax: 703-528-4367
Mailing address:
  • Phone: 703-528-3910
  • Fax: 703-528-4367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number0101243040
License Number StateVA

VIII. Authorized Official

Name: DR. AMY KOTECHA
Title or Position: OPHTHALMOLOGIST
Credential: MD
Phone: 347-886-6581