NORTHERN VIRGINIA EYE SURGERY CENTER LLC NPI 1407079155

NPI Information

NORTHERN VIRGINIA EYE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Fairfax, VA. NORTHERN VIRGINIA EYE SURGERY CENTER, LLC NPI is 1407079155. The provider is registered as an organization entity type.

The provider's business location address is:

2710 PROSPERITY AVE
SUITE 150
FAIRFAX, VA
ZIP 22031-320
Phone: (703) 289-1290
Fax: (703) 289-1298

The provider's authorized official is William Rich .
The authorized official title is Medical Director and has the following contact phone number (703) 534-3900.

The CLIA number assigned to this NPI record is 49D1071085 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 10/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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