Provider Demographics
NPI:1558553123
Name:ADVANCED VISION AND ACHIEVEMENT CENTERS INC
Entity Type:Organization
Organization Name:ADVANCED VISION AND ACHIEVEMENT CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-488-7007
Mailing Address - Street 1:3404 W CHERYL DR
Mailing Address - Street 2:STE 180
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9578
Mailing Address - Country:US
Mailing Address - Phone:602-863-2223
Mailing Address - Fax:602-863-0156
Practice Address - Street 1:3404 W CHERYL DR
Practice Address - Street 2:STE 180
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9578
Practice Address - Country:US
Practice Address - Phone:602-863-2223
Practice Address - Fax:602-863-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCLDMMedicare PIN