Organization
ANN POLONCAK
Active
Other names
Myeyedr
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE HEALEY (PRESIDENT)
(703) 847-8899
Entity
Organization
Contact information
Practice address
1100 S HAYES ST, ARLINGTON, VA 22202-4907
(703) 888-2999
(703) 888-2996
Mailing address
1950 OLD GALLOWS RD, SUITE 520, VIENNA, VA 22182-3990
(703) 847-8899
(703) 991-0514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601001615
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08434027
STATE TAX ID
MD
Enumeration date
02/20/2007
Last updated
02/07/2013
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