Bristow Optometry, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001573 Issued in VA

Legal business name

BRISTOW OPTOMETRY, LLC

Practice address

9930 Sowder Village SQ
Suite 220
Manassas, VA 20109-5464

Phone

(703) 368-2121

NPI assigned

Mar 23, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Neda Farahmand, OD

Title

Secretary

Phone

(703) 847-8899

Specialties & licenses 1

Addresses

Other names 1

• My Eye Dr Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1609017573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 SOWDER VILLAGE SQ",
            "address_2": "SUITE 220",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095464",
            "telephone_number": "703-368-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOW OPTOMETRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "FARAHMAND",
        "authorized_official_first_name": "NEDA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Eye Dr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "My Eye Dr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Manassas, VA
• Providers in Manassas, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.