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General NPI Number Information
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NPI Number | 1518361534
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Entity Type | Organization
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Legal Business Name | NEW ERA EYECARE, LLC
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 20789 GREAT FALLS PLZ STE 108
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City | STERLING
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State | VA
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Zip | 20165-2483
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Country | US
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Telephone | 571-375-7950
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Fax | 571-375-7961
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Provider Business Mailing Address
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Address Line | 5718 UNION MILL RD
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City | CLIFTON
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State | VA
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Zip | 20124-1088
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Country | US
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Telephone | 703-830-3977
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Fax | 703-830-0714
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. EDWIN R ADAIR III
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Credential | O.D.
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Telephone | 703-830-3977
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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 | 061800670
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License Number State | VA
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