Healthcare Provider Details
I. General information
NPI: 1871459602
Provider Name (Legal Business Name): OPTIVIEW FAMILY EYECARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4640 MONTICELLO AVE STE 8A
WILLIAMSBURG VA
23188-8230
US
IV. Provider business mailing address
104 KAITLYN CT
YORKTOWN VA
23693-2041
US
V. Phone/Fax
- Phone: 757-645-3930
- Fax:
- Phone: 757-645-3930
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AVANI
SIDDHAPURA
Title or Position: OPTOMETRIST
Credential: OD
Phone: 757-645-3930