National Provider Identifier Database

CRESTWOOD OPTICAL
Optician


Contact Information

CRESTWOOD OPTICAL
8078 SUDLEY RD
MANASSAS, VA20109
Phone: 703-369-1616
Fax: 703-369-7902
Website:
Specialty Taxonomy Code
* Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for CRESTWOOD OPTICAL

NPI Number 1275550089
Legal business name
LBN
CRESTWOOD OPTICAL
Authorized official ERIC KELLER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/16/2006
Last updated 06/20/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • VA License #: 967
  • VA Medicaid: 9282831

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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