Fairfax Eye Associates INC
Ophthalmology in Fairfax, VA. Organization (NPI-2).
NPI number1881663102
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1881663102
- Entity type
- Organization (NPI-2)
- Legal business name
- Fairfax Eye Associates INC
- Organization subpart
- No
- Enumeration date
- Mar 17, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | 0101024017 | VA | Yes |
| 207W00000X | Ophthalmology | 0101051247 | VA |
Practice location
9936 Main StFairfax, VA 22031
Phone 703-591-4884 · Fax 703-591-6932
Mailing address
9936 Main StFairfax, VA 22031
Phone 703-591-4884 · Fax 703-591-6932
Authorized official
Dertad Manguikian
Owner
7035914884
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