Provider Demographics
NPI:1275947707
Name:NATIONAL OPTOMETRY STEVEN KASINOF AND 17 ASSOCIATES OPTOMETRISTS
Entity Type:Organization
Organization Name:NATIONAL OPTOMETRY STEVEN KASINOF AND 17 ASSOCIATES OPTOMETRISTS
Other - Org Name:NATIONAL OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:O.D. / MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITELOCK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-263-2389
Mailing Address - Street 1:3750 VIRGINIA BEACH BLVD
Mailing Address - Street 2:STE. I
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-3411
Mailing Address - Country:US
Mailing Address - Phone:757-486-1712
Mailing Address - Fax:757-486-2962
Practice Address - Street 1:3750 VIRGINIA BEACH BLVD
Practice Address - Street 2:STE. I
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-3411
Practice Address - Country:US
Practice Address - Phone:757-486-1712
Practice Address - Fax:757-486-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA146314-5200-8042152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06084Medicare PIN