Provider Demographics
NPI:1942397526
Name:LEBOW EYE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:LEBOW EYE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEBOW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:804-458-5819
Mailing Address - Street 1:221 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-2809
Mailing Address - Country:US
Mailing Address - Phone:804-458-5819
Mailing Address - Fax:804-458-4580
Practice Address - Street 1:221 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2809
Practice Address - Country:US
Practice Address - Phone:804-458-5819
Practice Address - Fax:804-458-4580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0603000301152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5157010001Medicare NSC
C08988Medicare ID - Type Unspecified