Healthcare Provider Details

I. General information

NPI: 1598759839
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CARE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 SEMINARY RD SUITE 116
ALEXANDRIA VA
22311-1950
US

IV. Provider business mailing address

5001 SEMINARY RD SUITE 116
ALEXANDRIA VA
22311-1950
US

V. Phone/Fax

Practice location:
  • Phone: 703-931-2164
  • Fax: 703-931-2170
Mailing address:
  • Phone: 703-931-2164
  • Fax: 703-931-2170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HAFEZ DANESHVAR
Title or Position: OWNER
Credential: MD
Phone: 703-931-2164