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NPI Code Detail

MEDICARE: DULLES EYE ASSOCIATES, P.C.

MEDICARE: DULLES EYE ASSOCIATES, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist
2207W00000XOphthalmology Physician0101232401VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P0004567OTHERVARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114619OTHERVAANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
468480001OTHERDCCAREFIRST
52112890OTHERVAUNITED HEALTH CARE
6G8480001OTHERDCCAREFIRST

General Provider Information

NPI Number : 1144289661
Entity Type Code : Organization
Provider Name (Legal Business Name) : DULLES EYE ASSOCIATES, P.C.
Provider Business Mailing Address
First Line : 19415 DEERFIELD AVE
Second Line : STE 106
City : LANSDOWNE
State : VA
Zip : 20176-8452
Country : US
Telephone Number : 703-723-9633
Fax Number : 703-723-9772
Provider Business Practice Location Address
First Line : 19415 DEERFIELD AVE
Second Line : STE 106
City : LANSDOWNE
State : VA
Zip : 20176-8452
Country : US
Telephone Number : 703-723-9633
Fax Number : 703-723-9772
Authorized Official
Title or Position : OWNER
Name : MR. ABU AHMED NASRULLAH
Credential : MD
Telephone Number : 703-723-9633
Provider Enumeration Date : 03/22/2006
Last Update Date : 08/08/2025

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