Provider Demographics
NPI:1659919439
Name:N2 EYES OPTOMETRY LLC
Entity Type:Organization
Organization Name:N2 EYES OPTOMETRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-368-3937
Mailing Address - Street 1:11045 WARWICK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-3226
Mailing Address - Country:US
Mailing Address - Phone:757-596-4018
Mailing Address - Fax:757-516-7032
Practice Address - Street 1:11045 WARWICK BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3226
Practice Address - Country:US
Practice Address - Phone:757-596-4018
Practice Address - Fax:757-516-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1609978303Medicaid
VA1575823601Medicaid
VA1881653699Medicaid