Provider Demographics
NPI:1740469469
Name:A NEW VISION EYECARE AND LASER SURGERY, PLC
Entity type:Organization
Organization Name:A NEW VISION EYECARE AND LASER SURGERY, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REP
Authorized Official - Prefix:MS
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-449-0400
Mailing Address - Street 1:1464 MOUNT PLEASANT RD
Mailing Address - Street 2:UNIT 16 SUITE 309
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4043
Mailing Address - Country:US
Mailing Address - Phone:757-880-8969
Mailing Address - Fax:866-696-6573
Practice Address - Street 1:400 GRESHAM DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1901
Practice Address - Country:US
Practice Address - Phone:877-880-8969
Practice Address - Fax:877-807-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241378207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherTAX ID