Provider Demographics
NPI:1609279165
Name:ANEW VISION EYE SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:ANEW VISION EYE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANURADHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-787-2969
Mailing Address - Street 1:20325 N 51ST AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5677
Mailing Address - Country:US
Mailing Address - Phone:602-459-7267
Mailing Address - Fax:602-759-6075
Practice Address - Street 1:20325 N 51ST AVE STE 130
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5677
Practice Address - Country:US
Practice Address - Phone:602-459-7267
Practice Address - Fax:602-758-6075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44857207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty