Provider Demographics
NPI:1477545051
Name:EYE ASSOCIATES OF WINCHESTER INC.
Entity Type:Organization
Organization Name:EYE ASSOCIATES OF WINCHESTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:B
Authorized Official - Last Name:EISELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-662-4512
Mailing Address - Street 1:136 LINDEN DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6900
Mailing Address - Country:US
Mailing Address - Phone:540-678-3588
Mailing Address - Fax:540-678-9025
Practice Address - Street 1:1845 W PLAZA DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6365
Practice Address - Country:US
Practice Address - Phone:540-662-4512
Practice Address - Fax:540-722-5284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207W00000X
VA0101234941156FX1100X
VA0101229135156FX1100X
VA0101042504156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Multi-Specialty
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010001587Medicaid
VA010002991Medicaid
VA010072662Medicaid
VA006310508Medicaid
B08603Medicare UPIN
H91508Medicare UPIN
180000217Medicare ID - Type UnspecifiedNANCY B EISELE MD
VA006310508Medicaid
VA010072662Medicaid
004705E27Medicare ID - Type UnspecifiedALLA Y HYNES MD
VA010001587Medicaid
VAC01757Medicare PIN
VA010002991Medicaid