MOA MID-ATLANTIC LLC
NPI 1073279378
Optometrist in Chantilly, VA

Active since November 10, 2021
3910 CENTREVILLE RD STE 102, CHANTILLY, VA 20151(703) 719-8811(703) 263-2441 Get Directions Write a Review

NPPES record last updated: November 10, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Optometrist

About MOA MID-ATLANTIC LLC

This page provides the complete NPI Profile along with additional information for Moa Mid-atlantic Llc, a provider established in Chantilly, Virginia operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1073279378 assigned on November 2021. The practitioner's primary taxonomy code is 152W00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Moa Mid-atlantic Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Robert M Allen Od (Ceo / Doctor)

NPI
1073279378 Verify this NPI
Provider Name
MOA MID-ATLANTIC LLC
Entity Type
Organization
Location Address
3910 CENTREVILLE RD STE 102 CHANTILLY, VA 20151
Location Phone
(703) 719-8811
Location Fax
(703) 263-2441
Mailing Address
3910 CENTREVILLE RD STE 102 CHANTILLY, VA 20151
Mailing Phone
(703) 719-8811
Mailing Fax
(703) 263-2441
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-10-2021
Last Update Date
11-10-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Optometrist

Taxonomy Code
152W00000X
Type
Eye and Vision Services Providers
Taxonomy Description
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. ROBERT M ALLEN OD

Authorized Official Title
CEO / DOCTOR
Authorized Official Phone
(703) 719-8811

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Optometrist
3910 CENTREVILLE RD STE 102
CHANTILLY, VA 20151
Chiropractor (Neurology)
3910 CENTREVILLE RD STE 102
CHANTILLY, VA 20151
Chiropractor (Neurology)
3910 CENTREVILLE RD STE 102
CHANTILLY, VA 20151

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073279378, enumerated as an "organization" on November 10, 2021.

The provider is located at 3910 CENTREVILLE RD STE 102 CHANTILLY, VA 20151 and the phone number is (703) 719-8811.

Optometrist with taxonomy code 152W00000X.