Healthcare Provider Details

I. General information

NPI: 1043246614
Provider Name (Legal Business Name): SIMONA PICK BOTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CORINA SIMONA PIC MD

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8119 HOLLAND RD
ALEXANDRIA VA
22306-3135
US

IV. Provider business mailing address

8119 HOLLAND ROAD
ALEXANDRIA VA
22306
US

V. Phone/Fax

Practice location:
  • Phone: 703-383-8500
  • Fax:
Mailing address:
  • Phone: 703-383-8500
  • Fax: 833-411-6629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberMD035127
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101267770
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: