Provider Demographics
NPI:1568086304
Name:ENVUE EYE & LASER CENTER LLC
Entity Type:Organization
Organization Name:ENVUE EYE & LASER CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-485-9533
Mailing Address - Street 1:120 WATERFRONT ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1142
Mailing Address - Country:US
Mailing Address - Phone:301-485-9533
Mailing Address - Fax:
Practice Address - Street 1:120 WATERFRONT ST STE 300
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1142
Practice Address - Country:US
Practice Address - Phone:301-485-9533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-06
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty