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General NPI Number Information
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NPI Number | 1306593934
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Entity Type | Organization
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Legal Business Name | YOUREYEDOCTOR P.C.
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 43330 JUNCTION PLZ STE 120
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City | ASHBURN
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State | VA
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Zip | 20147-3407
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Country | US
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Telephone | 703-663-4290
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Fax | 888-920-2640
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Provider Business Mailing Address
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Address Line | 43330 JUNCTION PLZ STE 120
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City | ASHBURN
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State | VA
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Zip | 20147-3407
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Country | US
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Telephone | 703-663-4290
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Fax | 888-920-2640
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Authorized Official
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Title or Position | DOCOTOR OF OPTOMETRY OD, OWNER
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Name | MANDANA NASIRI MANESH
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Credential | OD
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Telephone | 703-663-4290
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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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