Provider Demographics
NPI:1275740615
Name:VIRGINIA EYE CENTER, P.C.
Entity Type:Organization
Organization Name:VIRGINIA EYE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NILOO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-858-9800
Mailing Address - Street 1:19441 GOLF VISTA PLAZA
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-858-9800
Mailing Address - Fax:703-858-9801
Practice Address - Street 1:1860 TOWN CENTER DR
Practice Address - Street 2:PARKWAY MEDICAL TOWER, SUITE G100
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5896
Practice Address - Country:US
Practice Address - Phone:703-858-9800
Practice Address - Fax:703-858-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========Medicaid
VA=========Medicaid