Provider Demographics
NPI:1013381847
Name:CLEARFINITY EYECARE PLLC
Entity Type:Organization
Organization Name:CLEARFINITY EYECARE PLLC
Other - Org Name:CLEARFINITY EYECARE OPTOMETRIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDERICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-293-5222
Mailing Address - Street 1:7807 LOCUST LEAF LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-6120
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9000 LORTON STATION BLVD
Practice Address - Street 2:STE M
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4748
Practice Address - Country:US
Practice Address - Phone:703-293-5222
Practice Address - Fax:703-293-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001477152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty