1740469469 NPI number — A NEW VISION EYECARE AND LASER SURGERY, PLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740469469 NPI number — A NEW VISION EYECARE AND LASER SURGERY, PLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A NEW VISION EYECARE AND LASER SURGERY, PLC
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:
1740469469
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1464 MOUNT PLEASANT RD
Provider Second Line Business Mailing Address:
UNIT 16 SUITE 309
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23322-4043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-880-8969
Provider Business Mailing Address Fax Number:
866-696-6573

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 GRESHAM DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23507-1901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-880-8969
Provider Business Practice Location Address Fax Number:
877-807-3937
Provider Enumeration Date:
10/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STEVENSON
Authorized Official First Name:
TONIA
Authorized Official Middle Name:
C
Authorized Official Title or Position:
BILLING REP
Authorized Official Telephone Number:
877-449-0400

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  0101241378 , 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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