Provider Demographics
NPI:1851729974
Name:DR. SURMATY AND ASSOCIATES THE VISION CENTER LLC
Entity Type:Organization
Organization Name:DR. SURMATY AND ASSOCIATES THE VISION CENTER LLC
Other - Org Name:DR. SURMATY AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:AIATULAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SURMATY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:571-340-5523
Mailing Address - Street 1:6416 WHIPPANY WAY
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3427
Mailing Address - Country:US
Mailing Address - Phone:571-340-5523
Mailing Address - Fax:
Practice Address - Street 1:400 SPOTSYLVANIA MALL
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-1123
Practice Address - Country:US
Practice Address - Phone:540-785-2763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002282152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty