Healthcare Provider Details

I. General information

NPI: 1790723385
Provider Name (Legal Business Name): PULMONARY ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5216 DAWES AVE
ALEXANDRIA VA
22311-1404
US

IV. Provider business mailing address

5216 DAWES AVE
ALEXANDRIA VA
22311-1404
US

V. Phone/Fax

Practice location:
  • Phone: 703-931-4746
  • Fax: 703-931-1794
Mailing address:
  • Phone: 703-931-4746
  • Fax: 703-931-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JOANN BACHNER
Title or Position: INSURANCE BILLING
Credential:
Phone: 703-931-4746