Provider Demographics
NPI:1114562626
Name:LASERVUE, LLC
Entity Type:Organization
Organization Name:LASERVUE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KOUROSH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-470-9798
Mailing Address - Street 1:5530 WISCONSIN AVE STE 1209
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4301
Mailing Address - Country:US
Mailing Address - Phone:301-363-2450
Mailing Address - Fax:301-363-2455
Practice Address - Street 1:5530 WISCONSIN AVE STE 1209
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4301
Practice Address - Country:US
Practice Address - Phone:301-363-2450
Practice Address - Fax:301-363-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty