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General NPI Number Information
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NPI Number | 1154458602
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Entity Type | Organization
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Legal Business Name | EYESIGHT OPTOMETRISTS PC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 1412 GREENBRIER PKWY SUITE 108A
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2832
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Country | US
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Telephone | 757-424-6095
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Fax | 757-424-4349
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Provider Business Mailing Address
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Address Line | 1412 GREENBRIER PKWY SUITE 108A
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2832
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Country | US
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Telephone | 757-424-6095
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Fax | 757-424-4349
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Authorized Official
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Title or Position | OWNER
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Name | DR. GARY D D'ANGELO
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Credential | OD
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Telephone | 757-424-0724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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