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General NPI Number Information
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NPI Number | 1437315074
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Entity Type | Organization
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Legal Business Name | ARTHUR ELEFTHERIO
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 11/29/2012
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Provider Practice Location Address
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Address Line | 7645 LEESBURG PIKE
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City | FALLS CHURCH
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State | VA
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Zip | 22043-2520
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Country | US
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Telephone | 703-790-0808
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Fax | 703-790-0708
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Provider Business Mailing Address
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Address Line | 7645 LEESBURG PIKE
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City | FALLS CHURCH
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State | VA
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Zip | 22043-2520
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Country | US
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Telephone | 703-790-0808
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Fax | 703-790-0708
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Authorized Official
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Title or Position | OD
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Name | ARTHUR ELEFTHERIO
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Credential |
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Telephone | 703-790-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 0618000160
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License Number State | VA
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