Healthcare Provider Details

I. General information

NPI: 1386723583
Provider Name (Legal Business Name): TRAHOS MEDICAL ENTERPRISES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S WHITING ST STE 303
ALEXANDRIA VA
22304-3632
US

IV. Provider business mailing address

205 S WHITING ST STE 303
ALEXANDRIA VA
22304-3632
US

V. Phone/Fax

Practice location:
  • Phone: 703-998-4913
  • Fax: 703-931-8171
Mailing address:
  • Phone: 703-998-4913
  • Fax: 703-931-8171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102035626
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number0102035626
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number0102035626
License Number StateVA

VIII. Authorized Official

Name: LORENA SIGALA
Title or Position: OFFICE MANAGER
Credential:
Phone: 703-998-4913