Provider Demographics
NPI:1194969519
Name:LASER VISION INSTITUTE OF THE VIRGIN ISLANDS LLC
Entity type:Organization
Organization Name:LASER VISION INSTITUTE OF THE VIRGIN ISLANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:ALLAIN
Authorized Official - Last Name:BARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-774-3003
Mailing Address - Street 1:8000 NISKY SHOPPING CTR STE 19B
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-5809
Mailing Address - Country:US
Mailing Address - Phone:340-774-3003
Mailing Address - Fax:866-896-5634
Practice Address - Street 1:8000 NISKY CTR.
Practice Address - Street 2:STE 19B
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-774-3003
Practice Address - Fax:866-896-5634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1005207W00000X, 261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty