Provider Demographics
NPI:1962044420
Name:ALICE TSENG OD OPTOMETRIST PLLC
Entity Type:Organization
Organization Name:ALICE TSENG OD OPTOMETRIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TSENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-862-2587
Mailing Address - Street 1:200 LAWYERS RD NW UNIT 83
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22183-8006
Mailing Address - Country:US
Mailing Address - Phone:703-865-5082
Mailing Address - Fax:703-865-5083
Practice Address - Street 1:6211 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2107
Practice Address - Country:US
Practice Address - Phone:703-862-2587
Practice Address - Fax:703-865-5083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service