Provider Demographics
NPI:1801976055
Name:NORTHERN VIRGINIA DOCTORS OF OPTOMETRY
Entity type:Organization
Organization Name:NORTHERN VIRGINIA DOCTORS OF OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:N
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-573-1200
Mailing Address - Street 1:7263E ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3219
Mailing Address - Country:US
Mailing Address - Phone:703-573-1200
Mailing Address - Fax:703-573-1250
Practice Address - Street 1:7263E ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3219
Practice Address - Country:US
Practice Address - Phone:703-573-1200
Practice Address - Fax:703-573-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618 000520152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9314OtherBCBS GROUP IDENTIFEIR
VA707911Medicare ID - Type UnspecifiedGROUP ID