Provider Demographics
NPI:1811243769
Name:VISUAL HEALTH DOCTORS OF OPTOMETRY
Entity type:Organization
Organization Name:VISUAL HEALTH DOCTORS OF OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHITWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-273-6323
Mailing Address - Street 1:10690 FAIRFAX BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4321
Mailing Address - Country:US
Mailing Address - Phone:703-273-6323
Mailing Address - Fax:703-273-6325
Practice Address - Street 1:10690 FAIRFAX BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4379
Practice Address - Country:US
Practice Address - Phone:703-273-6323
Practice Address - Fax:703-273-6325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001244152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA244422Medicare PIN