Provider Demographics
NPI: | 1548770035 |
---|---|
Name: | CATARACT VISION INSTITUTE VIRGINIA LLC |
Entity Type: | Organization |
Organization Name: | CATARACT VISION INSTITUTE VIRGINIA LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | AUTHORIZE OFFICIAL |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JONATHAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SOLOMON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 703-734-6030 |
Mailing Address - Street 1: | 8614 WESTWOOD CENTER DR STE 650 |
Mailing Address - Street 2: | |
Mailing Address - City: | VIENNA |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22182-2257 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 703-734-6030 |
Mailing Address - Fax: | 703-356-1758 |
Practice Address - Street 1: | 8614 WESTWOOD CENTER DR STE 650 |
Practice Address - Street 2: | |
Practice Address - City: | VIENNA |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22182-2257 |
Practice Address - Country: | US |
Practice Address - Phone: | 703-734-6030 |
Practice Address - Fax: | 703-356-1758 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-10-10 |
Last Update Date: | 2017-10-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Single Specialty |