Healthcare Provider Details

I. General information

NPI: 1144787276
Provider Name (Legal Business Name): SPRING VALLEY PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 MASSACHUSETTS AVE NW LOWR LEVEL
WASHINGTON DC
20016-4358
US

IV. Provider business mailing address

4900 MASSACHUSETTS AVE NW LOWR LEVEL
WASHINGTON DC
20016-4358
US

V. Phone/Fax

Practice location:
  • Phone: 202-966-5000
  • Fax: 202-966-5810
Mailing address:
  • Phone: 202-966-5000
  • Fax: 202-966-5810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA GUNERA
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 202-966-5000