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General NPI Number Information
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NPI Number | 1326385543
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Entity Type | Organization
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Legal Business Name | EYE INSTITUTE OF RESTON
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 1800 MICHAEL FARADAY DR SUITE 104
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City | RESTON
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State | VA
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Zip | 20190-5354
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Country | US
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Telephone | 703-537-8157
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Fax | 571-201-8672
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Provider Business Mailing Address
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Address Line | 1800 MICHAEL FARADAY DR SUITE 104
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City | RESTON
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State | VA
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Zip | 20190-5354
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Country | US
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Telephone | 703-537-8157
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Fax | 571-201-8672
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | DR. SHEEBANI BATHIJA GREWAL
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Credential | OD
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Telephone | 703-537-8157
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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 | 0618001503
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License Number State | VA
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