Provider Demographics
NPI:1396450300
Name:NEW VISION FAMILY EYE CLINIC LLC
Entity type:Organization
Organization Name:NEW VISION FAMILY EYE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MARJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOFIGH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:240-636-1515
Mailing Address - Street 1:23936 MILL WHEEL PL
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-4006
Mailing Address - Country:US
Mailing Address - Phone:240-636-1515
Mailing Address - Fax:
Practice Address - Street 1:420 MADISON TRADE PLZ SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3761
Practice Address - Country:US
Practice Address - Phone:240-636-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty