Provider Demographics
NPI:1871963488
Name:ASSOCIATES IN EYECARE-MERRIFIELD
Entity type:Organization
Organization Name:ASSOCIATES IN EYECARE-MERRIFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TESER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-297-4137
Mailing Address - Street 1:2672 AVENIR PL
Mailing Address - Street 2:SUITE L
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-7193
Mailing Address - Country:US
Mailing Address - Phone:703-297-4137
Mailing Address - Fax:
Practice Address - Street 1:2672 AVENIR PL
Practice Address - Street 2:SUITE L
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-7193
Practice Address - Country:US
Practice Address - Phone:703-297-4137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty