Provider Demographics
NPI:1659323475
Name:ELEFTHERIO, ARTHUR (OD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:ELEFTHERIO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7645 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2520
Mailing Address - Country:US
Mailing Address - Phone:703-790-0808
Mailing Address - Fax:703-790-0708
Practice Address - Street 1:7645 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2520
Practice Address - Country:US
Practice Address - Phone:703-790-0808
Practice Address - Fax:703-790-0708
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000160152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009203745Medicaid
VAP00906350Medicare PIN
VA178613Medicare PIN
VA009203745Medicaid