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NPI 1336204585

NPI 1336204585 : NORTHERN VIRGINIA EYE ASSOCIATES, PC : WOODBRIDGE, VA

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General NPI Number Information
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    NPI Number           |    1336204585
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    Entity Type          |    Organization 
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    Legal Business Name  |    NORTHERN VIRGINIA EYE ASSOCIATES, PC 
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Dates
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    Enumeration Date     |    12/27/2006
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    Last Update Date     |    04/28/2025
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Provider Practice Location Address
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    Address Line         |    14465 POTOMAC MILLS RD 
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    City                 |    WOODBRIDGE
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    State                |    VA
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    Zip                  |    22192-6807
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    Country              |    US
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    Telephone            |    703-494-6184
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    Fax                  |    703-499-9744
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Provider Business Mailing Address
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    Address Line         |    8614 WESTWOOD CENTER DR FL 9 
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    City                 |    VIENNA
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    State                |    VA
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    Zip                  |    22182-2442
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    Country              |    US
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    Telephone            |    703-847-8899
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    Fax                  |    571-223-6780
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Authorized Official
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    Title or Position    |    SECRETARY
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    Name                 |     SUE  DOWNES 
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    Credential           |    
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    Telephone            |    703-847-8899
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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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