1952787244 NPI number — NORTHERN VIRGINIA EYE INSTITUTE

Table of content: DR. ERIKA NICOLE TORJUSEN M.D. (NPI 1144405697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952787244 NPI number — NORTHERN VIRGINIA EYE INSTITUTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN VIRGINIA EYE INSTITUTE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952787244
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
311 PARK PLACE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARWATER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33759-4904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-483-7463
Provider Business Mailing Address Fax Number:
727-755-0679

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
212 LINDEN DR
Provider Second Line Business Practice Location Address:
SUITE 154
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22601-2894
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-313-4435
Provider Business Practice Location Address Fax Number:
540-313-4438
Provider Enumeration Date:
08/10/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SISKO
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
727-483-7463

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  0101237120 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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