Provider Demographics
NPI:1336415017
Name:NEW VISION EYE CARE, OD PA
Entity Type:Organization
Organization Name:NEW VISION EYE CARE, OD PA
Other - Org Name:TRIANGLE EYE INSTITUTE, OD PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SAID
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-881-0900
Mailing Address - Street 1:3214 CHARLES B ROOT WYND
Mailing Address - Street 2:SUITE 155
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-5440
Mailing Address - Country:US
Mailing Address - Phone:919-881-0900
Mailing Address - Fax:919-341-5273
Practice Address - Street 1:8210 RENAISSANCE PKWY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6688
Practice Address - Country:US
Practice Address - Phone:919-572-6771
Practice Address - Fax:919-572-6447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1776152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty