Provider Demographics
NPI:1457674152
Name:MEDICAL EYE CARE ASSOCIATES, PC
Entity Type:Organization
Organization Name:MEDICAL EYE CARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-366-3555
Mailing Address - Street 1:10410 MARBURY RD
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1620
Mailing Address - Country:US
Mailing Address - Phone:703-366-3555
Mailing Address - Fax:703-355-3606
Practice Address - Street 1:8717 DIGGES RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4403
Practice Address - Country:US
Practice Address - Phone:703-366-3555
Practice Address - Fax:703-366-3606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053808207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6305521Medicaid
VA6305521Medicaid
VA180000754Medicare PIN